| Background:The tests of blood clotting function were the regular tests for the hospital patients,normally contained the tests of prothrombin time(PT),international normalized ratio(INR),and fibrinogen(FIB)et.al.These tests results would be treated as criteria whether invasive detection and surgery would be done to protect the patients form the danger of bleeding.Blood platelets count was one test of blood routine examination,and it was also an important index of blood clotting.Most of the blood coagulation factors and enzymes were synthesized in liver cells,so it is easy to find the abnormal blood coagulation function in liver diseases patients.For example PT and INR would increased and the FIB and platelets would decreased in cirrhosis patients,so all of the factors mentioned had potential clinical significant as the diagnosis and predicting factors for the primary liver cancer patients and the value of these factors should be further verified.Methods:In this study,we had collected 5079 patients who had met the inclusion criteria.Among them 613 primary liver cancer patients who had accepted hepatectomy during February 2009 and July 2013 in Henan cancer hospital and had been followed-up 5 years,and 4466 hepatitis patients,cirrhosis patients and primary liver cancer patients who had treatment in the 302 hospital in Beijing were included.Among them 544 fibrosis patients who had accepted liver puncture and had pathology reports,and 3922 hepatitis,cirrhosis and primary liver cancer patients who had met the inclusion criterion of this study.By using student t test and one-way ANOVA the difference of coagulation factors between the patients in different backgrounds and different fibrosis degrees were tested.Kaplan-Meier and COX survival analysis were done to verify the predicting value of pre-surgery coagulation factors.Western blot was used to explain the possible reasons of fibrinogen as an alarming factor of primary liver cancer patients.Results:The results of one-way ANOVA analysis showed that both prothrombin time and international normalized ratio increased and platelets count decreased with the serious degree of fibrosis,however no trend was found in fibrinogen.By compare the different of clinical test results in hepatics,cirrhosis and primary liver cancer patients,the test results of liver functions in hepatics patients were better than that in primary liver cancer patients,cirrhosis patients had worst test results like Alb and PA.Fibrinogen did not like these factors highest level was found in primary liver cancer patients,for example the level in HBV relative hepatics,cirrhosis and primary liver cancer patients were 2.41g/L?2.17 g/L?3.43 g/L.Fibrinogen could be used as an alarming factor of primary liver cancer the under curve area and 95% CI were 0.790(0.751,0.785)?0.807(0.770,0.826)for HBV relative PLC and patients without hepatitis virus infection.The possible results of this phenomenon was that the abnormal metabolism of the fibrinogen.Pre-surgery international normalized ratio and fibrinogen were the independent predicting factors of HBV relative primary liver cancer patients,and the HR and 95% CI were 1.826(1.192,2.799)?1.234(1.023,1.488)respectively.Pre-surgery international normalized ratio was the independent predicting factors of primary liver cancer patients without hepatitis virus infection background the HR and 95%CI was 15.972(2.510,101.654).Conclusions:The pre-surgery clinical coagulation test results as prothrombin time,international normalized ratio and fibrinogen can be used as the predicting factors of post surgery primary liver cancer patients.What's more fibrinogen can be used as an alarm factor of HBV relative primary liver cancer patients and the patients without hepatitis faction,because of the metabolism disorder. |
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