The impact of chemotherapy on coagulation function in patients with gastrointestinal cancer / 中国综合临床

ABSTRACT

Objective To investigate the chemotherapy on coagulation function in patients with gastrointestinal cancer.Methods One hundred eight-one cases of gastrointestinal cancer patients who were taken chemotherapy in our hospital were collected from January 2009 to May 2012.According to tumor metastasis,they were divided into distant metastasis group ( n=68) and no distant metastasis group ( n=113 ),and then 270 cases of healthy persons were matched as control group.Plasma prothrombin time ( PT),activated partial thromboplastin enzyme time ( APTT),plasma fibrinogen ( FIB ),the total thrombin time ( TT),and D-dimer (DD) level were observed and compared between these groups.And the level of coagulation indicators in patients with gastrointestinal cancer was compared before and after chemotherapy.Results There were significant differences among three groups on levels of PT,APTT,FIB,TT and D-D (F=4.443,4.791,5.795,3.671,10.564,respectively,P＜0.05) before chemotherapy.The PT[(11.31 ±0.98) s and (11.20 ±0.95) s vs (11.99±0.89)s] and APTT[(29.01 ±4.52)s and (28.25 ±3.98)s vs (30.45 ±4.95)s] and TT [(19.35 ± 2.09) s and (18.68 ± 1.98 ) s vs (19.98 ± 1.89 ) s] in the tumor without distant metastasis and tumor distant metastasis groups were significantly lower than those in the healthy control group ( P＜0.05 ),however FIB[(3.05 ±0.68) g/L and (3.89 ± 1.01 ) g/L vs (2.29 ±0.38) g/L] and D-D[(98.88 ± 15.94) μg/L and (227.31 ± 35.12 ) μg/L vs (35.41 ± 3.43 ) μg/L] were significantly higher than those in the healthy control group (P＜0.05);FIB[(3.89 ± 1.01 ) g,/L vs (3.05±0.68) g/L],DD[(227.31 ± 35.12) μg/L vs (98.88 ± 15.94) μg/L] in distant metastasis group were also significantly higher than those in no distant metastasis group( P＜0.05 ).On comparison before and after chemotherapy,there was no significant difference on PT,APTT,D-D and TT between distant metastasis group and no distant metastasis group ( P ＞ 0.05 ),but FIB decreased significantly in two groups after chemotherapy [Distant metastasis group( 3.25 ± 0.78 ) g/L vs (3.89 ± 1.01) g/L;No distant metastasis group( 2.58 ± 0.75 ) g/L vs ( 3.05 ± 0.68 ) g/L;P＜0.05 )] Conclusion The patients with gastrointestinal cancer are on the hypercoagulable state.In addition,hypercoagulable state could be increased with the emergence of metastases.Chemotherapy may be a transient increasing in the risk of thrombosis.Clinicians need to recognize the hypercoagulable state in cancer patients before and after chemotherapy,that will provide help for clinical treatments.