Ferrigno D, Buccheri G
Azienda Ospedaliera S. Croce e Carle, Cuneo and Cuneo Lung Cancer Study Group, Cuneo, I-12100, Italy.
Monaldi Arch Chest Dis. 2003 Jul-Sep;59(3):193-8.
Many factors have prognostic significance in lung cancer. However, their practical value remains controversial except for stage of disease, performance status, and, perhaps, weight loss.
In the present study, counts of platelet (P), leukocyte (L), neutrophil (N), and hemoglobin serum content (Hb) were analyzed in 1201 new consecutive lung cancer patients. A set of 28 anthropometric, clinical, physical, laboratory, radiological, and pathological variables was prospectively recorded for all patients. Patients were carefully followed-up, and their subsequent clinical course recorded.
Anemia, leukocytosis, and thrombocytosis were present in 56%, 32%, and 17% of patients, respectively. Correlation tests showed that P was significantly correlated with L, N and Hb (rs = 0.353, 0.352, and -0.295, respectively). Other significant associations were those between Hb and Karnofsky Performance Status (KPS) (rs = 0.232), weight loss (rs = -0.210), and serum protein (rs = 0.263). N and L were correlated with KPS (rs = -0.217 and -0.186), stage of disease (rs = 0.153 and 0.135) and number of metastasis (rs = 0.121 and 0.109). Univariate analyses of survival showed that: a) abnormal values of L were prognosticantly significant in adenocarcinoma (p < 0.0001); b) patients with Hb < 13 g/dL had significantly shorter survivals (p = 0.0002); and c) thrombocytosis was associated to a poor outcome in patients with adenocarcinoma and epidermoid cancers (p = 0.0061 and 0.0072, respectively). The multivariate model selected, in decreasing order of significance, the following variables: 1) stage of disease; 2) KPS; 3) neutrophils; 4) age; and 5) sex.
This data indicates that only the leukocyte counts is an independent prognostic factors of survival in lung cancer.
许多因素对肺癌具有预后意义。然而，除了疾病分期、体能状态以及或许还有体重减轻外，它们的实际价值仍存在争议。
在本研究中，对1201例新诊断的连续性肺癌患者的血小板（P）、白细胞（L）、中性粒细胞（N）计数以及血红蛋白血清含量（Hb）进行了分析。前瞻性记录了所有患者的一组28项人体测量学、临床、体格检查、实验室、放射学和病理学变量。对患者进行了仔细的随访，并记录了他们随后的临床病程。
贫血、白细胞增多和血小板增多分别出现在56%、32%和17%的患者中。相关性检验表明，P与L、N和Hb显著相关（rs分别为0.353、0.352和 -0.295）。其他显著关联包括Hb与卡诺夫斯基体能状态（KPS）之间（rs = 0.232）、体重减轻之间（rs = -0.210）以及血清蛋白之间（rs = 0.263）。N和L与KPS相关（rs分别为 -0.217和 -0.186）、与疾病分期相关（rs分别为0.153和0.135）以及与转移灶数量相关（rs分别为0.121和0.109）。生存的单因素分析表明：a）L值异常在腺癌中具有预后意义（p < 0.0001）；b）Hb < 13 g/dL的患者生存时间显著缩短（p = 0.0002）；c）血小板增多与腺癌和鳞癌患者的不良预后相关（分别为p = 0.0061和0.0072）。所选择的多变量模型按重要性降序排列选择了以下变量：1）疾病分期；2）KPS；3）中性粒细胞；4）年龄；5）性别。
该数据表明，只有白细胞计数是肺癌生存的独立预后因素。
