[Change of coagulation in patients with gallbladder cancer and its clinical significance].
OBJECTIVE
To study the relationship between the change of coagulation and the clinicopathologic characteristics in patients with gallbladder cancer.


METHODS
The 64 gallbladder cancer patients (GBC group) and 60 cholecystitis patients (control group) had been reviewed from January 2007 to June 2013. The prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), and thrombin time (TT) had been measured and compared between patients of GBC group and control group. The relationship of coagulation function and prognosis were analyzed.


RESULTS
Compared with control group, APTT in GBC group ((29.0 ± 4.2) s) was significantly shortened (t = -4.265, P = 0.000) and PT ((11.5 ± 1.4) s), TT ((15.3 ± 3.5) s), Fib ((4.1 ± 0.9) g/L) were significantly increased in GBC group (t = 2.521, 4.147 and 4.365, all P < 0.05). The level of Fib was higher in patients with medium or poor-differentiated tumor cells (F = 4.069, P = 0.022), lymph metastasis (t = 2.640, P = 0.010) and advanced staging (II-IV) (t = 3.003, P < 0.01) than those of well-differentiated, non-lymph metastasis and early staging (0-I). The ratio of gallbladder cancer with hyperfibrinogenemia (32/64) was significantly higher than control group (11/60, χ(2) = 13.709, P < 0.01). In GBC group, compared with normal Fib patients, hyperfibrinogenemia patients showed significantly difference in clinicopathologic characteristics (χ(2) = 5.851-10.573, P < 0.05). The average survival period of hyperfibrinogenemia patients and normal Fib patients were 8.63 months and 16.73 months. The 1-, 3-year survival rate of patients with hyperfibrinogenemia were significantly lower than those with normal Fib (64.7%, 14.9% vs. 74.9%, 21.1%, P < 0.05).


CONCLUSIONS
Preoperative plasma level of Fib might be a new promising biomarker in patients with gallbladder cancer for evaluating disease progression and prognosis.
Research Institute of Biliary Tract Disease, Affiliated to Shanghai Jiaotong University, School of Medicine; Laboratory of General Surgery and Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200092, China.
Run-fa
RF
Bao
Yi-jun
YJ
Shu
Ping
P
Dong
Jun
J
Gu
Xiang-song
XS
Wu
Mao-lan
ML
Li
Hao
H
Weng
Qian
Q
Ding
Wen-guang
WG
Wu
Qi-chen
QC
Ding
Bo-yong
BY
Shen
Email: laoniulyb@163.com.
Ying-bin
YB
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D016022:Case-Control Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005706:Gallbladder Neoplasms / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011517:Prothrombin Time
D005340:Fibrinogen