Kies M S, Posch J J, Giolma J P, Rubin R N
Cancer. 1980 Aug 15;46(4):831-7. doi: 10.1002/1097-0142(19800815)46:4<831::aid-cncr2820460432>3.0.co;2-l.
We performed coagulation profiles including a complete blood count (CBC), prothrombin time (PT), activated partial thromboplastin time (aPTT), and quantitation of fibrinogen, antithrombin III (AT III), plasminogen, and fibrin/fibrinogen degradation products (FDP) on 73 cancer patients. All had solid tumors with clinically documented metastases. Eleven patients had strong clinical and laboratory evidence of disseminated intravascular coagulation (DIC). Fifty-five of the remaining 62 patients had no clinical evidence of serious hemorrhage or thrombosis at the time of testing. Thirty-one (50%) non-DIC patients had no abnormal clotting tests. Our data indicate that a majority of cancer patients, with or without hepatic involvement, are able to maintain normal or near normal hemostatic function in vitro until advanced stage of disease. Deviation from normal for PT, aPTT, or TT, depressed AT III activity, or increased FDP signal the presence of complicating pathophysiologic events such as DIC or cirrhosis. Diminution of fibrinogen level or AT III activity and elevation of FDP are more sensitive indicators of DIC than prolongation of PT, aPTT, or TT.
我们对73例癌症患者进行了凝血指标检测，包括全血细胞计数（CBC）、凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）以及纤维蛋白原、抗凝血酶III（AT III）、纤溶酶原和纤维蛋白/纤维蛋白原降解产物（FDP）的定量检测。所有患者均患有实体瘤且有临床记录的转移。11例患者有弥散性血管内凝血（DIC）的有力临床和实验室证据。其余62例患者中，55例在检测时无严重出血或血栓形成的临床证据。31例（50%）非DIC患者的凝血检测无异常。我们的数据表明，大多数癌症患者，无论有无肝脏受累，在疾病晚期之前体外均能维持正常或接近正常的止血功能。PT、aPTT或凝血酶时间（TT）偏离正常、AT III活性降低或FDP升高提示存在诸如DIC或肝硬化等复杂的病理生理事件。纤维蛋白原水平或AT III活性降低以及FDP升高是比PT、aPTT或TT延长更敏感的DIC指标。
