凝血标志物作为结直肠癌侵袭性的独立预测指标。

Coagulation markers as independent predictors of colorectal cancer aggressiveness.

作者信息

El-Sayed Hanaa Ali, Sakr Doaa H, Abdelhakiem Mostafa, Ebrahim Mohamed Awad, Othman Maha, Azzam Hanan

机构信息

Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Oncology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

BMC Gastroenterol. 2025 Sep 2;25(1):634. doi: 10.1186/s12876-025-04249-4.

DOI:10.1186/s12876-025-04249-4

PMID:40898085

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12403284/

Abstract

BACKGROUND

Colorectal cancer (CRC) is frequently associated with thrombosis with thrombotic events, such as deep vein thrombosis or pulmonary embolism, often correlate with poor clinical outcomes. Coagulation markers have been suggested as potential prognostic indicators for CRC severity. However, the relationship with clinicopathological characteristics in CRC remains unclear.

PURPOSE

This study aims to examine the relationship between routine coagulation markers and clinicopathological characteristics in CRC patients.

PATIENTS AND METHODS

A retrospective analysis was conducted on 100 patients with confirmed diagnosis of CRC, classified according to the 2018 edition of the American Joint Committee on Cancer Tumor/Node/Metastasis staging system for malignant tumors. Clinicopathological characteristics and routine coagulation tests including prothrombin time, and international normalized ratio, activated partial thromboplastin time, prothrombin activity, thrombin time, fibrinogen, d-dimer, platelet count, were evaluated. Spearman correlation was used to assess correlations with clinicopathological characteristics. Additionally, univariate and multivariate ordinal regression analysis were conducted to detect the independent predictors for CRC aggressiveness.

RESULTS

Our data documents several associations between coagulation markers and cancer progression markers. Specifically, positive correlations were identified between fibrinogen and d-dimer levels and each of the following: carcinoembryonic antigen, carbohydrate antigen, tumor stage, node involvement, and metastasis. Regression analysis showed, d-dimer (OR = 1.102, < 0.001) and fibrinogen (OR = 1.002, < 0.001) are independent predictors of high-risk CRC cases.

CONCLUSION

Fibrinogen and d-dimer may serve as independent predictive biomarkers for CRC aggression. Their clinical utility could support personalized treatment plans for CRC patients.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12876-025-04249-4.

摘要

背景

结直肠癌（CRC）常与血栓形成相关，血栓事件，如深静脉血栓形成或肺栓塞，往往与不良临床结局相关。凝血标志物已被认为是CRC严重程度的潜在预后指标。然而，其与CRC临床病理特征的关系仍不明确。

目的

本研究旨在探讨CRC患者常规凝血标志物与临床病理特征之间的关系。

患者与方法

对100例确诊为CRC的患者进行回顾性分析，根据2018版美国癌症联合委员会恶性肿瘤肿瘤/淋巴结/转移分期系统进行分类。评估临床病理特征和常规凝血试验，包括凝血酶原时间、国际标准化比值、活化部分凝血活酶时间、凝血酶原活性、凝血酶时间、纤维蛋白原、D-二聚体、血小板计数。采用Spearman相关性分析评估与临床病理特征的相关性。此外，进行单因素和多因素有序回归分析以检测CRC侵袭性的独立预测因素。

结果

我们的数据记录了凝血标志物与癌症进展标志物之间的几种关联。具体而言，纤维蛋白原和D-二聚体水平与以下各项之间均存在正相关：癌胚抗原、糖类抗原、肿瘤分期、淋巴结受累和转移。回归分析显示，D-二聚体（OR = 1.102，P < 0.001）和纤维蛋白原（OR = 1.002，P < 0.001）是高危CRC病例的独立预测因素。