Qiu Miao-zhen, Yuan Zhong-yu, Luo Hui-yan, Ruan Dan-yun, Wang Zhi-qiang, Wang Feng-hua, Li Yu-hong, Xu Rui-hua
State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.
Tumour Biol. 2010 Aug;31(4):255-60. doi: 10.1007/s13277-010-0024-x. Epub 2010 Mar 25.
Pretreatment hematologic abnormalities have been reported to have prognostic value in patients with solid tumors. The aim of our study was to determine the prevalence of abnormalities in the hematologic profile in patients with colorectal cancer before treatment and to evaluate if such a profile could be used for prognostic evaluations. We identified all patients in Cancer Center of Sun Yat-Sen University who were diagnosed as colorectal cancers between May 2005 and August 2009. All subjects were investigated regarding levels of white blood cells, platelets, and hemoglobin concentration. Survival was compared by using the log-rank test on the Kaplan-Meier life table. Multivariate Cox regression analysis was used to evaluate if the pretreatment hematologic profile was independent prognostic factor. We identified 363 patients with colorectal cancer and 315 patients with benign diseases for the final analysis. The percentages of leukocytosis, anemia, and thrombocytosis were significantly higher in colorectal cancer patients than in patients with benign diseases. Univariate analysis showed that advanced tumor stages, leukocytosis, anemia, thrombocytosis, and low histological grade were all significantly associated with shorter survival. The multivariate Cox analysis revealed that low histological grade, tumor stage, pretreatment anemia, and thrombocytosis remained independent prognostic variables for survival. The cumulative effect of anemia and thrombocytosis yielded shorter survival. Anemia and thrombocytosis can be considered as useful prognostic markers in patients with colorectal cancer.
据报道，治疗前血液学异常对实体瘤患者具有预后价值。我们研究的目的是确定结直肠癌患者治疗前血液学指标异常的发生率，并评估这样的指标是否可用于预后评估。我们确定了中山大学肿瘤防治中心2005年5月至2009年8月期间被诊断为结直肠癌的所有患者。对所有受试者的白细胞、血小板水平及血红蛋白浓度进行了检测。采用Kaplan-Meier生存表上的对数秩检验比较生存率。使用多变量Cox回归分析评估治疗前血液学指标是否为独立的预后因素。我们确定了363例结直肠癌患者和315例良性疾病患者进行最终分析。结直肠癌患者白细胞增多、贫血和血小板增多的百分比显著高于良性疾病患者。单因素分析显示，肿瘤晚期、白细胞增多、贫血、血小板增多和低组织学分级均与较短的生存期显著相关。多变量Cox分析显示，低组织学分级、肿瘤分期、治疗前贫血和血小板增多仍然是生存的独立预后变量。贫血和血小板增多的累积效应导致生存期缩短。贫血和血小板增多可被视为结直肠癌患者有用的预后标志物。
