Rai S, Hemingway D
Department of General Surgery, University Hospitals of Leicester, Leicester, UK.
Colorectal Dis. 2005 Nov;7(6):588-90. doi: 10.1111/j.1463-1318.2005.00880.x.
Diagnosis of right-sided colon cancers requires total colonic imaging. The decision as to when a symptomatic patient should undergo a complete colonic imaging is difficult. It has been suggested that the presence of iron deficiency anaemia in such patients can be a useful tool in making that decision, as the vast majority of proximal colon cancers are anaemic. Our study aimed to evaluate the relation between proximal colon cancers and anaemia.
A list of 194 patients who underwent a right hemicolectomy for colon cancer was extracted from our hospital cancer database. The haemoglobin levels of each of these patients at the time of their referral were identified. The proportion of these patients, who had anaemia as per locally agreed guidelines, was determined.
Only 44% of the men and 57% of women with proximal colon cancer were found to be anaemic. Even after using higher cut-off levels for 'low' haemoglobin, a significant proportion of patients were not anaemic.
Anaemia is a poor predictor of right-sided colon cancers and cannot be used as an effective investigative tool in symptomatic patients.
右侧结肠癌的诊断需要对全结肠进行成像。对于有症状的患者何时应进行全结肠成像的决策较为困难。有人提出，此类患者中缺铁性贫血的存在可能是做出该决策的有用工具，因为绝大多数近端结肠癌患者都有贫血症状。我们的研究旨在评估近端结肠癌与贫血之间的关系。
从我院癌症数据库中提取了194例行右半结肠切除术治疗结肠癌的患者名单。确定了这些患者在转诊时各自的血红蛋白水平。根据当地商定的指南，确定这些患者中贫血患者的比例。
发现近端结肠癌男性患者中仅有44%、女性患者中仅有57%存在贫血。即使采用更高的血红蛋白“低”值临界水平，仍有相当比例的患者没有贫血。
贫血对右侧结肠癌的预测能力较差，不能作为有症状患者的有效检查工具。
