Ho Chao-Hung, Yu Yuan-Bin, Wu Ping-Hao
Department of Internal Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
J Chin Med Assoc. 2008 Mar;71(3):119-22. doi: 10.1016/S1726-4901(08)70002-9.
Gastrointestinal (GI) tract malignancy is an important cause of chronic iron deficiency anemia (IDA). The present study was designed to determine the prevalence of IDA and its clinical implications in colorectal cancer patients.
We performed a retrospective study of 101 patients who were admitted to Taipei Veterans General Hospital with proven colorectal carcinoma from 2003-2005. We reviewed the discharge charts and recorded the following data: gender, age, tumor size, tumor site, tumor stage, clinical symptoms, complete blood counts, serum iron (SI), total iron binding capacity (TIBC), serum ferritin, lactate dehydrogenase (LDH) and carcinoembryonic antigen (CEA). The patients were divided into 2 groups: 1 with and the other without anemia. Different variables of the 2 groups were compared and analyzed to find out the risk factors of anemia in patients with colorectal cancer.
A total of 101 patients, with a mean age of 65.3 years, were enrolled; 56 were male. Their mean hemoglobin was 11.8 g/dL. Fifty-one patients (51%) were found to have anemia. Multivariate logistic regression analysis showed that female gender, tumor in the right colon (cecum, ascending colon, hepatic flexure), and maximum tumor diameter >or= 3 cm were risk factors of anemia in patients with colon carcinoma. Serum ferritin had been measured in 25 patients, and low ferritin level (< 40 micro/L) was found in 15 (60%) of them. CEA and LDH were elevated in 45% (43/95) and 46% (43/93) of patients with colorectal cancer, respectively.
Iron deficiency anemia is a common clinical manifestation of patients with colorectal carcinoma, and occurred more frequently in females, patients with right colon tumor and with larger tumor size.
胃肠道恶性肿瘤是慢性缺铁性贫血（IDA）的重要病因。本研究旨在确定缺铁性贫血在结直肠癌患者中的患病率及其临床意义。
我们对2003年至2005年入住台北荣民总医院且确诊为结直肠癌的101例患者进行了回顾性研究。我们查阅了出院病历并记录了以下数据：性别、年龄、肿瘤大小、肿瘤部位、肿瘤分期、临床症状、全血细胞计数、血清铁（SI）、总铁结合力（TIBC）、血清铁蛋白、乳酸脱氢酶（LDH）和癌胚抗原（CEA）。患者分为两组：一组有贫血，另一组无贫血。比较和分析两组的不同变量，以找出结直肠癌患者贫血的危险因素。
共纳入101例患者，平均年龄65.3岁；男性56例。他们的平均血红蛋白为11.8 g/dL。发现51例患者（51%）患有贫血。多因素逻辑回归分析显示，女性、右半结肠（盲肠、升结肠、肝曲）肿瘤以及最大肿瘤直径≥3 cm是结肠癌患者贫血的危险因素。对25例患者进行了血清铁蛋白检测，其中15例（60%）铁蛋白水平低（<40 μg/L）。结直肠癌患者中CEA和LDH升高的分别占45%（43/95）和46%（43/93）。
缺铁性贫血是结直肠癌患者常见的临床表现，在女性、右半结肠肿瘤患者和肿瘤较大的患者中更常见。
