Fractal dimension (df) as a new structural biomarker of clot microstructure in different stages of lung cancer.
Fractal dimension (df) as a new structural biomarker of clot microstructure in different stages of lung cancer.
复制标题
分形维数（df）作为肺癌不同阶段凝块微观结构的新结构生物标志物。
DOI：
10.1160/th15-04-0357
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发表时间：
2015
影响因子：
6.7
通讯作者：
Davies NA
中科院分区：
文献类型：
--
作者：
Davies NA
静脉血栓栓塞（VTE）在癌症患者中很常见，并且是与该疾病相关的第二常见死亡原因。患有慢性炎症（例如癌症）的患者已被证明具有机械性质调制的病理性凝块结构。分形维数（df）是一种新的技术，已被证明可以作为血液凝块的微观结构和机械性能的标志，并且可以比目前的方法，如扫描电子显微镜（SEM）更容易地进行。我们测量了87例治疗前新诊断肺癌的连续患者和47例匹配的对照组的dfin。比较所有肺癌患者与对照组以及局限性疾病与广泛性疾病的平均组值。结果与传统的凝血、纤溶指标和SEM图像进行了比较。与对照组相比，肺癌患者的df值显著更高，广泛性病变患者的df值高于局限性病变患者（p< 0.05），而常规标记物无法区分这两组。通过SEM和计算模型证实了早期凝块和成熟凝块微观结构的df之间的关系：与对照组相比，肺癌患者中较高的df与由较小纤维蛋白纤维形成的高密度凝块相关。这项研究表明，df是一种敏感的技术，可以量化肺癌患者血凝块的结构和机械特性。我们的数据表明，df有可能识别具有异常凝块微结构和最大VTE风险的患者。
Venous thromboembolism (VTE) is common in cancer patients, and is the second commonest cause of death associated with the disease. Patients with chronic inflammation, such as cancer, have been shown to have pathological clot structures with modulated mechanical properties. Fractal dimension (df) is a new technique which has been shown to act as a marker of the microstructure and mechanical properties of blood clots, and can be performed more readily than current methods such as scanning electron microscopy (SEM). We measured dfin 87 consecutive patients with newly diagnosed lung cancer prior to treatment and 47 matched-controls. Mean group values were compared for all patients with lung cancer vs controls and for limited disease vs extensive disease. Results were compared with conventional markers of coagulation, fibrinolysis and SEM images. Significantly higher values of dfwere observed in lung cancer patients compared with controls and patients with extensive disease had higher values than those with limited disease (p< 0.05), whilst conventional markers failed to distinguish between these groups. The relationship between dfof the incipient clot and mature clot microstructure was confirmed by SEM and computational modelling: higher dfwas associated with highly dense clots formed of smaller fibrin fibres in lung cancer patients compared to controls. This study demonstrates that dfis a sensitive technique which quantifies the structure and mechanical properties of blood clots in patients with lung cancer. Our data suggests that dfhas the potential to identify patients with an abnormal clot micro-structure and greatest VTE risk.