头颈部癌患者治疗前血液学指标的预后意义
Prognostic significance of a pretreatment hematologic profile in patients with head and neck cancer.
作者信息
Chen Ming-Huang, Chang Peter Mu-Hsin, Chen Po-Min, Tzeng Cheng-Hwai, Chu Pen-Yuan, Chang Shyue-Yih, Yang Muh-Hwa
机构信息
Division of Hematology-Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
出版信息
J Cancer Res Clin Oncol. 2009 Dec;135(12):1783-90. doi: 10.1007/s00432-009-0625-1. Epub 2009 Jun 24.
BACKGROUND
The purpose of this retrospective study was to test whether the pretreatment hematologic profile can predict the prognosis of patients with head and neck cancer.
METHODS
Medical records from 278 patients with head and neck cancer were reviewed, and 270 cases were evaluable. Clinical data including age, gender, stage, pretreatment hematologic profile (including white blood cell, platelet, and differential counts, and hemoglobin level) were recorded. Statistical analyses were performed to determine the prognostic effect of these hematologic indicators, as well as clinical variables. The association between the hematologic indicators and clinical factors was also analyzed.
RESULTS
Pretreatment monocytes >1,000 cells/microl (P = 0.028), hemoglobin <11.0 g/dl (P = 0.022), and platelet count >400 x 10(3) cells/microl (P = 0.017) were identified as independent prognostic factors in addition to the nodal status and metastasis. A significant correlation between T-stage/monocyte or platelet count and metastasis/platelet count were shown. Monocytosis, anemia, and thrombocytosis were demonstrated to have a cumulative effect on the prognosis of head and neck cancer patients (normal vs. abnormality in one lineage, P = 0.001; abnormality in one vs. more than one lineage, P = 0.005).
CONCLUSIONS
A pretreatment hematologic profile can be considered as a useful prognostic marker in patients with head and neck cancer.
背景
本回顾性研究的目的是检验治疗前血液学指标是否能够预测头颈部癌患者的预后。
方法
回顾了278名头颈部癌患者的病历，其中270例可进行评估。记录了包括年龄、性别、分期、治疗前血液学指标（包括白细胞、血小板、分类计数及血红蛋白水平）等临床数据。进行统计分析以确定这些血液学指标以及临床变量的预后影响。还分析了血液学指标与临床因素之间的关联。
结果
除淋巴结状态和转移外，治疗前单核细胞>1000个/微升（P = 0.028）、血红蛋白<11.0 g/dl（P = 0.022）以及血小板计数>400×10³个/微升（P = 0.017）被确定为独立的预后因素。T分期/单核细胞或血小板计数与转移/血小板计数之间显示出显著相关性。单核细胞增多、贫血和血小板增多对头颈部癌患者的预后具有累积影响（一个谱系正常与异常，P = 0.001；一个谱系异常与一个以上谱系异常，P = 0.005）。
结论
治疗前血液学指标可被视为头颈部癌患者有用的预后标志物。
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