实验室血液数据对晚期直肠癌术前放化疗中的肿瘤反应和预后有显著影响。
Laboratory blood data have a significant impact on tumor response and outcome in preoperative chemoradiotherapy for advanced rectal cancer.
作者信息
Yasuda Koji, Sunami Eiji, Kawai Kazushige, Nagawa Hirokazu, Kitayama Joji
机构信息
Department of Surgical Oncology, Faculty of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
出版信息
J Gastrointest Cancer. 2012 Jun;43(2):236-43. doi: 10.1007/s12029-011-9268-y.
INTRODUCTION
Although neoadjuvant chemoradiotherapy (CRT) is the standard treatment for advanced rectal cancer (RC), markers predicting response have not been adequately defined.
PATIENTS AND METHODS
In 73 cases with advanced RC, we evaluated the tumor response with the reduction rate of the longitudinal size of RC using barium enema image taken before and after CRT. Then, we retrospectively examined the association with various blood values taken before CRT. The tumor size reduction rate was significantly greater in ten CR cases than in 63 non-CR cases (p < 0.001).
RESULTS
Interestingly, the size reduction ratio was positively associated with hemoglobin, albumin level and lymphocyte percentage in leukocytes, while being negatively associated with platelet counts, C-reactive protein and fibrinogen levels as well as neutropliles percentage. Moreover, high lymphocyte counts (>1,800/mm(3)) had an independent association with disease-free survival.
CONCLUSIONS
Blood data have a major impact on the tumor response to CRT. Control of host condition may improve the effectiveness of CRT in advanced RC.
引言
尽管新辅助放化疗（CRT）是晚期直肠癌（RC）的标准治疗方法，但预测反应的标志物尚未得到充分定义。
患者与方法
在73例晚期RC患者中，我们使用CRT前后拍摄的钡灌肠图像，通过RC纵向尺寸的缩小率评估肿瘤反应。然后，我们回顾性研究了其与CRT前采集的各种血液值之间的关联。10例CR病例的肿瘤大小缩小率明显高于63例非CR病例（p < 0.001）。
结果
有趣的是，缩小率与血红蛋白、白蛋白水平以及白细胞中的淋巴细胞百分比呈正相关，而与血小板计数、C反应蛋白和纤维蛋白原水平以及中性粒细胞百分比呈负相关。此外，高淋巴细胞计数（>1,800/mm³）与无病生存期独立相关。
结论
血液数据对肿瘤对CRT的反应有重大影响。控制宿主状况可能会提高CRT对晚期RC的疗效。
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