Göğüş Cağatay, Baltaci Sümer, Filiz Ercan, Elhan Atilla, Bedük Yaşar
Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
Urology. 2004 Mar;63(3):447-50. doi: 10.1016/j.urology.2003.10.039.
To evaluate the significance of thrombocytosis for determining survival in patients with localized renal cell carcinoma (RCC) who underwent radical nephrectomy with curative intent.
The study population comprised 151 patients who underwent radical nephrectomy with a diagnosis of localized RCC. The inclusion criteria were at least one preoperative platelet count and a tissue diagnosis of RCC. Thrombocytosis was defined as a platelet count greater than 400,000/mm3. The charts of these patients were retrospectively reviewed and the relationship between the preoperative platelet counts and survival was evaluated according to the histologic variants.
The mean follow-up was 37.1 +/- 24.1 months (median 34, range 3 to 91). Of these 151 patients, 21 had a preoperative platelet count greater than 400,000/mm3. The thrombocytosis rate was significantly greater in those with advanced T stage (P = 0.045). Lymph node positivity also correlated with thrombocytosis (P = 0.028). However, no statistically significant correlation was found between grade and histologic subtypes and thrombocytosis (P = 0.053 and P = 0.354, respectively). Ten (47.6%) of 21 patients with thrombocytosis and 21 (16.2%) of the remaining 130 patients died of disease progression (P = 0.002). The Kaplan-Meier cause-specific survival curves showed that patients who had thrombocytosis had a mean survival of 45.2 months compared with 76.6 months in patients without thrombocytosis (P = 0.0002).
Preoperative thrombocytosis is a significant predictor for determining prognosis in patients with localized RCC. Thrombocytosis was found more frequently in patients with advanced stage RCC, and patients with preoperative thrombocytosis had a worse survival compared with those with normal platelet counts.
评估血小板增多症对于判定接受根治性肾切除术且有治愈意图的局限性肾细胞癌（RCC）患者生存情况的意义。
研究人群包括151例经诊断为局限性RCC并接受根治性肾切除术的患者。纳入标准为至少有一次术前血小板计数及RCC的组织学诊断。血小板增多症定义为血小板计数大于400,000/mm³。对这些患者的病历进行回顾性分析，并根据组织学亚型评估术前血小板计数与生存之间的关系。
平均随访时间为37.1±24.1个月（中位数34个月，范围3至91个月）。在这151例患者中，21例术前血小板计数大于400,000/mm³。T分期较晚的患者中血小板增多症发生率显著更高（P = 0.045）。淋巴结阳性也与血小板增多症相关（P = 0.028）。然而，未发现分级和组织学亚型与血小板增多症之间存在统计学显著相关性（分别为P = 0.053和P = 0.354）。21例血小板增多症患者中有10例（47.6%），其余130例患者中有21例（16.2%）死于疾病进展（P = 0.002）。Kaplan-Meier特定病因生存曲线显示，血小板增多症患者的平均生存期为45.2个月，而无血小板增多症患者为76.6个月（P = 0.0002）。
术前血小板增多症是判定局限性RCC患者预后的重要预测指标。晚期RCC患者中血小板增多症更为常见，术前血小板增多症患者的生存情况较血小板计数正常的患者更差。
