文章摘要
张津铭,于牧鑫,王瑞峰,李文莹,解汝娟.组织因子阳性的细胞和微粒在胃癌高凝状态中的作用[J].,2018,(21):4081-4086
组织因子阳性的细胞和微粒在胃癌高凝状态中的作用
Tissue Factor-exposing Cells and Microparticels induce Procoagulant Activity in Gastric Cancer
投稿时间:2018-04-30  修订日期:2018-05-26
DOI:10.13241/j.cnki.pmb.2018.21.017
中文关键词: 胃癌  组织因子  血小板  白细胞  微粒  高凝状态
英文关键词: Gastric cancer  Tissue factor  Platelet  Leukocyte  Microparticle  Hypercoagulability
基金项目:国家自然科学基金项目(81670659);黑龙江省自然科学基金项目(H2017024)
作者单位
张津铭 哈尔滨医科大学附属第四医院消化内科 黑龙江 哈尔滨 150001 
于牧鑫 哈尔滨医科大学附属第一医院肾内科 黑龙江 哈尔滨 150001 
王瑞峰 哈尔滨医科大学附属第四医院消化内科 黑龙江 哈尔滨 150001 
李文莹 哈尔滨医科大学附属第一医院肾内科 黑龙江 哈尔滨 150001 
解汝娟 哈尔滨医科大学附属第一医院肾内科 黑龙江 哈尔滨 150001 
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中文摘要:
      摘要 目的:探讨胃癌患者血浆中组织因子阳性的血小板、白细胞和微粒的数量及其促凝活性。方法:将45例胃癌患者根据TNM分期分为I、II、III、IV期,同时选取30例健康人作为对照组。采用流式细胞术检测组织因子阳性的细胞和微粒数。凝血酶生成实验检测细胞和微粒的凝血活性。结果:胃癌III/IV期患者血浆中组织因子阳性的血小板、中性粒细胞、单核细胞和微粒的数量明显高于胃癌I/II期和健康对照组。胃癌III/IV期患者血小板、白细胞和微粒的促凝活性与其他组相比显著升高,与增加凝血酶的生成速度和生成总量有关。用抗组织因子抗体抑制TF后,细胞和微粒的凝血活性明显下降。然而,使用抗膜连蛋白V抑制PS后,细胞和微粒的凝血活性虽然有下降趋势,但是并不明显。此外,根治性手术治疗可以降低组织因子阳性的血小板、中性粒细胞、单核细胞和微粒的数量。结论:组织阳性的血小板、中性粒细胞、单核细胞和微粒是胃癌III/IV患者高凝状态的原因之一,通过抑制TF和凝血酶的生成可能降低胃癌患者的血栓发生率。
英文摘要:
      ABSTRACT Objective: This study was designed to evaluate whether exposed tissue factor (TF) on platelets, leukocyte and mi- croparticles were involved in the hypercoagulability of gastric cancer. Methods: Gastric cancer patients were divided into four groups based on tumor-node-metastasis (TNM) stage, defined as stage I (n=10), stage II (n=10), stage III (n=15) or stage IV (n=10), and com- pared with healthy controls (n=30). Flow cytometry was used to quantify the counts of tissue factor positive cells and microparticels. The procoagulant activity of cells and microparticles were tested by thrombin production assays. Results: Using flow cytometry, we found TF+ platelets, neutrophils, monocytes and microparticles were significantly higher in stage III/IV patiens than in stage I/II patients and healthy controls. Moreover, the TF+ blood cells cooperated with microparticels, contributing to the increased rate and levels of thrombin formation. In addition, blockade of exposed TF on cells and micrparticles with anti-TF antibody significantly inhibited the procoagulant activity. However, blockade of exposed PS with annexin V has little effect on the procoagulant activity. Meanwhile, we found that treat- ment with radical resection could reduce the number of TF+ platelets, neutrophils, monocytes and microparticles. Conclusion: Our results suggest that TF+ platelets, leukocyte and microparticles play procoagulant roles in patients with gastric cancer. Blockade of TF and inhib- ite the formation of thrombin maybe the therapeutic target to prevent coagulation in patients with stage III/IV gastric cancer.
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