Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
World J Surg. 2012 Jan;36(1):192-200. doi: 10.1007/s00268-011-1329-7.
Although thrombocytosis has been reported in patients with various types of cancer, the association between thrombocytosis and the clinicopathological features of patients with colorectal cancer (CRC) has not been fully investigated. We evaluated the clinical features associated with thrombocytosis in CRC.
The medical records of 636 consecutive CRC patients undergoing surgery in our department between January 2002 and July 2008 were retrospectively reviewed. The correlation between the clinicopathological variables and the preoperative platelet count was analyzed by univariate and multivariate analyses. The impact of thrombocytosis on the prognosis of these patients was assessed, in comparison with the other clinicopathological variables.
Platelet count showed significant correlation with gender, age, venous involvement, tumor size, depth of invasion, regional lymph node metastasis, distant metastasis in univariate analysis, and tumor size and depth of invasion were independent factors in multivariate analysis. The cancer-specific survival (CSS) of CRC patients with thrombocytosis was significantly shorter than that for those without thrombocytosis (P < 0.001), specifically in patients with stage III CRC (P < 0.001). Multivariate analysis indicated that thrombocytosis was an independent prognostic factor of CSS (hazard ratio = 2.96, 95% confidence interval [CI] = 1.72-5.00). Moreover, within stage II CRC, the univariate analysis revealed that disease-free survival (DFS) was associated with preoperative thrombocytosis, but not the other clinicopathological variables.
Preoperative thrombocytosis is not only an independent indicator of poor CSS in CRC patients but also an independent predictor of poor DFS in patients with stage II CRC.
虽然血小板增多症已在各种类型的癌症患者中被报道，但血小板增多症与结直肠癌（CRC）患者的临床病理特征之间的关系尚未被充分研究。我们评估了与 CRC 中血小板增多症相关的临床特征。
回顾性分析了 2002 年 1 月至 2008 年 7 月在我院行手术治疗的 636 例连续 CRC 患者的病历。通过单因素和多因素分析评估了临床病理变量与术前血小板计数之间的相关性。与其他临床病理变量相比，评估了血小板增多症对这些患者预后的影响。
血小板计数在单因素分析中与性别、年龄、静脉侵犯、肿瘤大小、浸润深度、区域淋巴结转移、远处转移呈显著相关，在多因素分析中肿瘤大小和浸润深度是独立因素。血小板增多症 CRC 患者的癌症特异性生存率（CSS）明显短于无血小板增多症患者（P<0.001），尤其是在 III 期 CRC 患者中（P<0.001）。多因素分析表明血小板增多症是 CSS 的独立预后因素（风险比=2.96，95%置信区间[CI]：1.72-5.00）。此外，在 II 期 CRC 中，单因素分析显示无病生存率（DFS）与术前血小板增多症相关，但与其他临床病理变量无关。
术前血小板增多症不仅是 CRC 患者 CSS 不良的独立指标，也是 II 期 CRC 患者 DFS 不良的独立预测因子。
