Research The Relationship Between Non-small Cell Lung Cancer And Hypercoagulable State

Objective:To detect the plasma level of VEGF, TF, D-dimer, platelet and fibrinogen in patients with non-small-cell lung cancer and study the relationship between VEGF, TF, D-dimer, platelet, fibrinogen and thromboembolic events.Methods:Collected104non-small cell lung cancer patients for the first time diagnosed in department of respiratory, oncology and thoracic surgery of the affiliated hospital of Qingdao university from January2013to December2013.21cases of lung cancer patient concurrent venous thromboembolism as lung cancer and venous thromboembolism group, other83cases without venous thrombosis as lung cancer group, at the same period select80cases of healthy people as control group, record data of platelet and fibrinogen. The plasma level of VEGF, TF and D-dimer were detected by enzyme-linked immunosorbent assay (ELISA).Results:1. The level of VEGF, TF and D-dimer in lung cancer and venous thromboembolism group [(1185.34±321.98) pg/ml,(1637.30±45.12) pg/ml,(1387.87±290.16)μg/L] was significantly higher than that of lung cancer group [(680.56±199.37) pg/ml,(1208.02±298.43) pg/ml,(596.30±118.60)μg/L] and healthy control group [(214.73±59.34) pg/ml,(581.27±123.24) pg/ml,(220.35±49.93) μg/L],(P<0.01). The level of VEGF, TF and D-dimer in lung cancer group was significantly higher than healthy control group (P<0.01).2. There were no significantly difference of VEGF, TF and D-dimer level in lung cancer group with different gender and age (P>0.05).3. In different pathological types the level of VEGF and D-dimer in adenocarcinoma was higher than squamous carcinoma and large cell carcinoma, the level of TF in large cell carcinoma was slightly higher, but these differences were not statistically significant (P>0.05).4. The level of VEGF and TF relates to TNM stage. The level of VEGF in stage Ⅰ-Ⅱ, stage Ⅲ and stage Ⅳ were (496.69±114.95) pg/ml,(681.56±55.63) pg/ml,(815.87±100.83) pg/ml, difference between groups was statistically significant (F=29.01, P<0.01). The level of TF in stage Ⅰ-Ⅱ, stage Ⅲ and stage Ⅳ were (996.94±170.19) pg/ml,(1200.15±267.91) pg/ml,(1459.82±290.35) pg/ml, difference between groups was statistically significant (F=12.33, P<0.01). The level of D-dimer is higher in patients with advanced TNM stages, but there were no significantly difference between each group (F=0.084, P>0.05).5. The level of VEGF in platelet increase and no increase group of lung cancer patients were (730.95±112.09) pg/ml vs (598.46±178.15) pg/ml, there were significantly difference between two groups(P<0.05). The level of TF in platelet increase and no increase group of lung cancer patients were (1327.93±316.68) pg/ml vs (1113.60±250.29) pg/ml, there were significantly difference between two groups(P<0.05). The level of D-dimer in platelet increase and no increase group of lung cancer patients were (661.38±176.73)μg/L vs (543.90±128.25) μg/L, there were significantly difference between two groups(P<0.05).6. The level of VEGF in fibrinogen increase and no increase group of lung cancer patients were (754.56±161.15) pg/ml vs (638.21±150.25) pg/ml, there were significantly difference between two groups(P<0.05). The level of TF in fibrinogen increase and no increase group of lung cancer patients were (1375.62±310.96) pg/ml vs (1129.71±290.22) pg/ml, there were significantly difference between two groups(P<0.05). The level of D-dimer in fibrinogen increase and no increase group of lung cancer patients were (661.59±176.76)μg/L vs (543.89±125.59) μg/L, there were significantly difference between two groups(P<0.05).7. The level of VEGF and D-dimer in lung cancer patients was positively correlated(r=0.46, P<0.01). D-dimer levels were positively correlated with TF (r=0.32, P<0.05), VEGF levels were also positively correlated with TF levels (r=0.54, P<0.01).Conclusion:1. The level of VEGF, TF and D-dimer can assess the risk of venous thrombosis in patients with non-small cell lung cancer.2. There were no significantly difference of VEGF, TF and D-dimer level in lung cancer patients with different gender and age.3. The level of VEGF, TF and D-dimer was not significantly different in different pathological types, but a high level VEGF expression in adenocarcinoma. This suggested that adenocarcinoma was easy to early invasive, metastasis and venous thrombosis.4. The level of VEGF and TF relates to TNM stage, it proves that VEGF, TF can promote tumor growth, metastasis and the risk of venous thrombosis increases with the TNM stage. There was no correlation between D-dimer level and TNM stage.5. The expression of VEGF, TF and D-dimer increased in lung cancer patients with increased plasma fibrinogen and platelet, shows that patients more easily for venous thrombosis increased plasma fibrinogen and platelet.6. The plasma level of D-dimer in lung cancer patients was positively correlated with the level of VEGF and TF, and VEGF levels were also positively correlated with TF levels.