To analyze the relationship between the coagulation function changes and the malignancy degrees in the patients with non-small cell lung cancer (NSCLC) in order to provide bases for clinical prediction and judgment of the progress and metastasis of lung cancer patients.

In this study, 99 patients with NSCLC who were treated in our hospital from January 2017 to October 2018 were taken as a case group (the NSCLC group) and 40 healthy subjects in the same period were taken as a control group. According to the pathological type, the case group was divided into a squamous cell carcinoma group (n=23 cases) and an adenocarcinoma group (n=76 cases). A total of 50 patients had no lymph node metastasis and 49 had lymph node metastasis. Fourteen patients had no extra-lung/pleural metastasis and 13 had lung/pleural metastasis. According to the Eighth Edition of Lung Cancer TNM Staging, stage Ⅰ was found in 26 cases, stage Ⅱ in 22, stage Ⅲ in 24, and stage Ⅳ in 27. The patients with stage Ⅲ and stage Ⅳ lung cancer were divided into a clinical benefit group (n=42 cases) and a clinical progression group (n=9 cases), respectively, after two courses of conventional chemotherapy. The coagulation function, D-dimer and platelet count were detected in the two groups, and their clinical significance was analyzed. The changes of coagulation function under different clinical and pathological factors were compared and analyzed.

Compared with the control group, the prothrombin time (PT, P<0.001) and the international normalized ratio (INR, P<0.001) were significantly shortened in the NSCLC group, while the fibrinogen (FIB, P<0.001) and the thrombin time (D-D, P<0.001) were significantly increased. Group analysis of the clinical and pathological factors in the patients with NSCLC found that PT (P<0.001), FIB (P=0.002), the activated partial thromboplastin time (APTT, P=0.028) and INR (P=0.043) were higher in the patients with squamous cell carcinoma than in the patients with adenocarcinoma. The levels of PT (P<0.001), FIB (P<0.001) and APTT (P<0.001) increased in stage Ⅳ patients with NSCLC compared with those of stage Ⅰ-Ⅲ patients. The levels of PT (P<0.001), FIB (P<0.001) and APTT (P<0.001) increased in N1-3 patients with NSCLC compared with those of the controls. There was no significant difference in blood coagulation indexes between the patients with or without extra-lung/pleural metastasis (P>0.05). In the clinical benefit group, PT, INR and D-D were shortened (P=0.007, P=0.036, and P=0.034, respectively) and TT increased (P=0.013) after chemotherapy compared with those before chemotherapy. There was no significant difference in the level of coagulation indexes between the clinical advanced group.

The coagulation function of the patients with NSCLC is generally abnormal and it has a certain correlation with the pathological type and the tumor stage. The patients with lung squamous cell carcinoma, in the advanced stage and with lymph node metastasis are more prone to hypercoagulability. PT and INR shortening and TT prolongation can be used as an early indicator of the efficacy of chemotherapy in the patients with NSCLC and can increase the occurrence of thrombotic events.