Seda Carlos Javier Ortega, Salas Alberto San Juan, Sánchez Cristina García, Blasco José María Lozano, García Ignacio Osman, Sánchez José Manuel Conde, Ruíz Carmen Belén Congregado, Navarro Salvador Mármol, López Rafael Antonio Medina
Clinical Management in Urology and Nephrology Unit, University Hospital Virgen del Rocio, Sevilla, Spain.
Arch Esp Urol. 2011 Nov;64(9):883-90.
To examine the connection between preoperative thrombocytosis and hematocrit and survival in a group of patients operated for renal cell carcinoma.
Retrospective study with descriptive and statistical analysis of 139 patients with renal cell carcinoma treated surgically over the last 4 years in our Urology clinical unit. 116 (83,45%)were diagnosed at a localized clinical stage, whereas 23 (16,54%) presented as locally advanced or metastatic disease. We collected data about survival and time on surveillance, imaging and histological characteristics of the tumor and analytical parameters. Data were analyzed by the SPSS statistical software.
The average platelet count and hematocrit before surgery were 260,930 cells/mm3 and 41.10%, respectively. We found a statistical correlation between platelet count at the time of diagnosis and survival. Patients with platelet counts higher than 350,000 cells/mm3 had a poor survival (OR: 2.94; CI 95% 1.04- 8.27). We also found that patients with high hematocrit at diagnosis presented a lower risk of death (OR: 0.92; CI 95% 0.85- 0.99). The global survival at the end of the study was 88.4%. Multivariate analysis did not show any significant result because of the low number of deaths.
The presence of high platelet count or low hematocrit correlate with poor survival in a group of surgically treated renal cell carcinoma patients. Nevertheless more studies with longer surveillance and higher number of patients are needed.
探讨一组接受肾细胞癌手术治疗患者术前血小板增多症与血细胞比容及生存率之间的关系。
对过去4年在我们泌尿外科临床科室接受手术治疗的139例肾细胞癌患者进行回顾性研究，并进行描述性和统计分析。116例（83.45%）在局部临床分期时被诊断，而23例（16.54%）表现为局部晚期或转移性疾病。我们收集了关于生存情况、监测时间、肿瘤的影像学和组织学特征以及分析参数的数据。数据采用SPSS统计软件进行分析。
术前平均血小板计数和血细胞比容分别为260,930个细胞/mm³和41.10%。我们发现诊断时的血小板计数与生存率之间存在统计学相关性。血小板计数高于350,000个细胞/mm³的患者生存率较差（比值比：2.94；95%置信区间1.04 - 8.27）。我们还发现诊断时血细胞比容高的患者死亡风险较低（比值比：0.92；95%置信区间0.85 - 0.99）。研究结束时的总体生存率为88.4%。由于死亡人数较少，多变量分析未显示任何显著结果。
在一组接受手术治疗的肾细胞癌患者中，血小板计数高或血细胞比容低与生存率差相关。然而，需要进行更多监测时间更长、患者数量更多的研究。
