Qiu Miao-zhen, Xu Rui-hua, Ruan Dan-yun, Li Zhuang-hua, Luo Hui-yan, Teng Kai-yuan, Wang Zhi-qiang, Li Yu-hong, Jiang Wen-qi
State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.
Tumour Biol. 2010 Dec;31(6):633-41. doi: 10.1007/s13277-010-0079-8. Epub 2010 Jul 23.
Despite the fact that malignancies are associated with hematological abnormalities, some clinical studies have been unable to detect such a relation. The aim of our study was to detect the prevalence of pretreatment hematologic abnormalities in patients with common solid tumors and to determine 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 solid tumors (breast carcinoma, hepatocellular carcinoma, nasopharyngeal carcinoma, esophageal carcinoma, gastric cancer, cervical carcinoma, endometrial cancer, renal cell carcinoma, and non-small cell lung cancer) between January 2000 and August 2009. All subjects were investigated regarding levels of white blood cells, platelets, and hemoglobin concentration. We identified 3,180 patients with solid tumors and 285 patients with benign diseases for the final analysis. The percentages of leukocytosis, anemia, and thrombocytosis in patients with solid tumors ranged from 4.0% to 25.6%, 3.3% to 29.2%, and 2.1% to 9.7%, respectively. The multivariate Cox analysis revealed that anemia was an independent prognostic factor in patients with breast cancer (P = 0.006), hepatocellular carcinoma (P = 0.002), nasopharyngeal carcinoma (P = 0.008), and esophageal carcinoma (P = 0.001). Leukocytosis was an independent prognostic factor in patients with cervical cancer (P = 0.007). The incidence of hematological abnormalities in Chinese patients with solid tumors was relatively lower than that of the counterparts in the Western countries. A pretreatment anemia or leukocytosis can serve as a useful marker to predict outcome of patients in some of the solid tumors.
尽管恶性肿瘤与血液学异常有关,但一些临床研究未能检测到这种关系。我们研究的目的是检测常见实体瘤患者治疗前血液学异常的患病率,并确定这样的特征是否可用于预后评估。我们确定了中山大学肿瘤防治中心在2000年1月至2009年8月期间被诊断为实体瘤(乳腺癌、肝细胞癌、鼻咽癌、食管癌、胃癌、宫颈癌、子宫内膜癌、肾细胞癌和非小细胞肺癌)的所有患者。对所有受试者进行了白细胞、血小板和血红蛋白浓度水平的调查。我们确定了3180例实体瘤患者和285例良性疾病患者进行最终分析。实体瘤患者中白细胞增多、贫血和血小板增多的百分比分别为4.0%至25.6%、3.3%至29.2%和2.1%至9.7%。多因素Cox分析显示,贫血是乳腺癌(P = 0.006)、肝细胞癌(P = 0.002)、鼻咽癌(P = 0.008)和食管癌(P = 0.001)患者的独立预后因素。白细胞增多是宫颈癌患者的独立预后因素(P = 0.007)。中国实体瘤患者血液学异常的发生率相对低于西方国家的患者。治疗前贫血或白细胞增多可作为预测某些实体瘤患者预后的有用标志物。