Kristensen S D, Bath P M, Gladwin A M, Martin J F
Department of Medicine, Royal Hallamshire Hospital, Sheffield.
Br J Haematol. 1992 Jun;81(2):247-51. doi: 10.1111/j.1365-2141.1992.tb08215.x.
This study investigates megakaryocyte size in bronchial carcinoma and its relationship to platelet count, mean platelet volume and platelet function, the latter determined in vivo by measurement of the cutaneous bleeding time. Measurements were performed in 19 patients with bronchial carcinoma and 11 patients with a hiatus hernia (controls). Platelet count (335 +/- 123 v. 241 +/- 72 x 10(9)/l) and megakaryocyte total area (772 +/- 135 v. 666 +/- 105 microns 2) (mean +/- standard deviation) were both significantly increased in patients with bronchial carcinoma when compared to controls whilst the bleeding time was shorter in the patient group (253 +/- 116 v. 321 +/- 80 s). Patients with bronchial carcinoma were older (60.2 +/- 8.4 v. 48.8 +/- 13.2 years) and smoked more heavily (760 +/- 511 v. 92 +/- 175 cigarette years) than controls. Megakaryocyte size, platelet count and bleeding time all correlated with smoking habit (r = 0.395, P = 0.031; r = 0.622, P less than 0.001; r = 0.515, P = 0.004 respectively). There were no statistically significant differences between the groups with respect to gender or mean platelet volume. When considering all patients, significant correlations existed between platelet count and megakaryocyte area (r = 0.400, P = 0.029), and bleeding time and megakaryocyte area (r = -0.365, P = 0.047). The megakaryocyte nuclear and cytoplasmic areas were positively correlated (r = 0.855, P less than 0.001). This study suggests that the elevated platelet count in patients with bronchial carcinoma is mediated by an increase in the size of bone marrow megakaryocytes although the results are compounded by the association between smoking and megakaryocyte/platelet parameters.
本研究调查了支气管癌患者巨核细胞大小及其与血小板计数、平均血小板体积和血小板功能的关系，后者通过测量皮肤出血时间在体内进行测定。对19例支气管癌患者和11例食管裂孔疝患者（对照组）进行了测量。与对照组相比，支气管癌患者的血小板计数（335±123对241±72×10⁹/L）和巨核细胞总面积（772±135对666±105平方微米）（均值±标准差）均显著升高，而患者组的出血时间较短（253±116对321±80秒）。支气管癌患者比对照组年龄更大（60.2±8.4对48.8±13.2岁）且吸烟更严重（760±511对92±175支年）。巨核细胞大小、血小板计数和出血时间均与吸烟习惯相关（分别为r = 0.395，P = 0.031；r = 0.622，P＜0.001；r = 0.515，P = 0.004）。两组在性别或平均血小板体积方面无统计学显著差异。在考虑所有患者时，血小板计数与巨核细胞面积之间存在显著相关性（r = 0.400，P = 0.029），出血时间与巨核细胞面积之间也存在显著相关性（r = -0.365，P = 0.047）。巨核细胞核面积与细胞质面积呈正相关（r = 0.855，P＜0.001）。本研究表明，支气管癌患者血小板计数升高是由骨髓巨核细胞大小增加介导的，尽管吸烟与巨核细胞/血小板参数之间的关联使结果变得复杂。
