Taucher Susanne, Salat Andreas, Gnant Michael, Kwasny Werner, Mlineritsch Brigitte, Menzel Rainer-Christian, Schmid Marianne, Smola Michael G, Stierer Michael, Tausch Christoph, Galid Arik, Steger Günther, Jakesz Raimund
Department of Surgery, University of Vienna Medical School, Waehringer Guertel 18-20, Vienna A-1090, Austria.
Thromb Haemost. 2003 Jun;89(6):1098-106.
Platelet count has been reported to have predictive value in various cancer entities. In the case of breast cancer, evidence about involvement of platelets is still incomplete. Our objective was to assess the influence of pretreatment thrombocytosis on survival and establish its prognostic relevance for breast cancer patients. We performed a retrospective, multivariate analysis of 4,300 patients with early-stage breast cancer. All subjects participated in one of five prospective, randomized, multicenter trials conducted by the Austrian Breast and Colorectal Cancer Study Group. Thrombocytosis was defined as a platelet count exceeding 400 G/L. Median follow-up was 52 months. Univariate and multiple Cox regression models were calculated for overall survival (OS), breast cancer-related survival and disease-free survival (DFS). Pretreatment thrombocytosis was observed in 161 patients (3.7%). Estimated median OS, breast cancer-related survival and DFS for patients with versus those without thrombocytosis was 71.0 versus 99.5, 72.0 versus 100.9, and 80.4 versus 88.4 months, respectively (p = 0.0054, p = 0.0095, p = 0.0199). A multiple Cox regression model including tumor and nodal status, grading, age, hormone receptor status and pretreatment thrombocytosis identified pretreatment thrombocytosis as an independent predictive factor for OS (p = 0.0064) and breast cancer-related survival (p = 0.0162). Multivariate analysis failed to identify pretreatment thrombocytosis as an independent risk factor for DFS (p = 0.1355). In our retrospective study, elevated platelet counts at time of diagnosis were associated with poor prognosis in breast cancer. We hypothesize that platelets may contribute to the pathophysiology of hematogenous metastasis.
据报道，血小板计数在多种癌症实体中具有预测价值。就乳腺癌而言，关于血小板参与情况的证据仍不完整。我们的目的是评估预处理时血小板增多对生存的影响，并确定其对乳腺癌患者的预后相关性。我们对4300例早期乳腺癌患者进行了回顾性多变量分析。所有受试者均参与了奥地利乳腺癌和结直肠癌研究组开展的五项前瞻性、随机、多中心试验之一。血小板增多定义为血小板计数超过400 G/L。中位随访时间为52个月。计算了总生存（OS）、乳腺癌相关生存和无病生存（DFS）的单变量和多变量Cox回归模型。161例患者（3.7%）观察到预处理时血小板增多。血小板增多患者与无血小板增多患者的估计中位OS、乳腺癌相关生存和DFS分别为71.0对99.5、72.0对100.9和80.4对88.4个月（p = 0.0054，p = 0.0095，p = 0.0199）。一个包含肿瘤和淋巴结状态、分级、年龄、激素受体状态及预处理时血小板增多的多变量Cox回归模型将预处理时血小板增多确定为OS（p = 0.0064）和乳腺癌相关生存（p = 0.0162）的独立预测因素。多变量分析未能将预处理时血小板增多确定为DFS的独立危险因素（p = 0.1355）。在我们的回顾性研究中，诊断时血小板计数升高与乳腺癌预后不良相关。我们推测血小板可能参与血行转移的病理生理过程。
