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2023年埃塞俄比亚西北部癌症治疗中心乳腺癌患者的凝血谱:一项比较性横断面研究。

Coagulation profiles of breast cancer patients attending at cancer treatment centres in Northwest Ethiopia 2023: a comparative cross-sectional study.

作者信息

Ayana Sisay, Aynalem Melak, Adane Tiruneh, Shiferaw Elias

机构信息

Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia.

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

出版信息

Sci Rep. 2025 May 15;15(1):16979. doi: 10.1038/s41598-025-02104-w.

Abstract

Breast cancer is the primary cause of cancer-related deaths in women, especially in developing nations where early detection and comorbidity management are challenging. Coagulopathy significantly enhance the disease severity, but its impact on Ethiopian patients is unclear. Therefore, this study aims to investigate and compare coagulation profiles in chemotherapy-experienced, chemotherapy-naive breast cancer patients, and healthy controls. An Institutional-based comparative cross-sectional study was conducted at the University of Gondar and Felege Hiwot Comprehensive Specialized Hospitals from 15 May 2023 to 30 August 2023 on a total of 180 participants. Participants socio-demographic and clinical data were collected using structured questionnaires in face-to-face interviews and medical record reviews. Blood sample for laboratory tests were taken, with 3 ml in ethylenediaminetetraacetic acid, 3 ml in trisodium citrate, and 2 ml in serum separator tubes. Coagulation parameters were measured using Genrui coagulation analyser (CA51) and Sysmex KX-21 hematology analyser. Data entry was done using Epi Data version 4.6 and transform to SPSS version 25 for analysis then descriptive statistics was presenting with tables. One-way ANOVA and Kruskal-Wallis tests were used to compare coagulation parameters among the three study groups, considering normal and skewed data, respectively. The activated partial thromboplastin time in chemotherapy-experienced, chemotherapy-naïve patients, and healthy controls showed median ± IQR values of 34.3 ± 15.8, 35 ± 13.3, and 29.2 ± 5.9 s, respectively, indicating a significant difference (p: 0.016). Similarly, the prothrombin time in the same groups had median ± IQR values of 15 ± 3.9, 15.3 ± 2.9, and 13.2 ± 1.9 s, respectively, with a significant difference (p < 0.001). Platelet count mean ± SD in chemotherapy-experienced, chemotherapy-naïve patients, and healthy controls were 351.3 ± 99.6, 345.6 ± 117.5, and 284.3 ± 79.3, respectively, showing a significant difference (p < 0.001). The mean ± SD of mean platelet volume in the same groups were 10.4 ± 2.7, 9.5 ± 2.4, and 9 ± 1.2, respectively, with a significant difference (p: 0.003). Coagulation parameters of both chemotherapy-experienced and chemotherapy-naïve patients were abnormally prolonged compared to healthy controls. This event indicates in vivo coagulation and it may increase bleeding tendency in patients. Therefore, early laboratory investigation of the coagulation profiles of breast cancer patients is critical for early detection and intervention of the coagulopathy.

摘要

乳腺癌是女性癌症相关死亡的主要原因,尤其是在早期检测和合并症管理具有挑战性的发展中国家。凝血病会显著加重疾病的严重程度,但其对埃塞俄比亚患者的影响尚不清楚。因此,本研究旨在调查和比较有化疗经历、无化疗经历的乳腺癌患者以及健康对照者的凝血谱。2023年5月15日至2023年8月30日,在贡德尔大学和费莱格·希沃特综合专科医院开展了一项基于机构的比较横断面研究,共有180名参与者。通过面对面访谈使用结构化问卷以及查阅病历,收集参与者的社会人口统计学和临床数据。采集用于实验室检测的血样,3毫升置于乙二胺四乙酸管中,3毫升置于枸橼酸钠管中,2毫升置于血清分离管中。使用格睿凝血分析仪(CA51)和希森美康KX - 21血液分析仪测量凝血参数。数据录入使用Epi Data 4.6版本,然后转换为SPSS 25版本进行分析,描述性统计结果以表格形式呈现。分别使用单因素方差分析和Kruskal - Wallis检验来比较三个研究组之间的凝血参数,分别考虑正态数据和偏态数据。有化疗经历的患者、无化疗经历的患者以及健康对照者的活化部分凝血活酶时间的中位数±四分位间距分别为34.3±15.8秒、35±13.3秒和29.2±5.9秒,差异有统计学意义(p:0.016)。同样,同一组中凝血酶原时间的中位数±四分位间距分别为15±3.9秒、15.3±2.9秒和13.2±1.9秒,差异有统计学意义(p<0.001)。有化疗经历的患者、无化疗经历的患者以及健康对照者的血小板计数平均值±标准差分别为351.3±99.6、345.6±117.5和284.3±79.3,差异有统计学意义(p<0.001)。同一组中平均血小板体积的平均值±标准差分别为10.4±2.7、9.5±2.4和9±1.2,差异有统计学意义(p:0.003)。与健康对照者相比,有化疗经历和无化疗经历的患者的凝血参数均异常延长。这一情况表明体内存在凝血现象,可能会增加患者的出血倾向。因此,对乳腺癌患者凝血谱进行早期实验室检查对于凝血病的早期检测和干预至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc5/12081868/072a20ce223c/41598_2025_2104_Fig1_HTML.jpg

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