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围手术期外周血单核细胞计数的变化可能预测结直肠肝转移患者肝切除术后的预后。

Perioperative change in peripheral blood monocyte count may predict prognosis in patients with colorectal liver metastasis after hepatic resection.

机构信息

Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

J Surg Oncol. 2012 Jul 1;106(1):31-5. doi: 10.1002/jso.23033. Epub 2012 Jan 9.

Abstract

BACKGROUND

Prognostic value of perioperative change in peripheral blood leukocyte subset count of cancer patients have not been fully investigated. Therefore, we retrospectively investigated the relation between perioperative change in peripheral blood monocyte count and disease-free as well as overall survival after hepatic resection for colorectal liver metastasis (CRLM).

METHODS

The subjects were 64 patients who underwent hepatic resection for CRLM between January 2000 and December 2008. We retrospectively investigated the relation between perioperative change in peripheral blood monocyte count and disease-free as well as overall survival.

RESULTS

In multivariate analysis, more than four lymph node metastases (P = 0.0298) and extrahepatic disease (P = 0.0423) were significant predictors of disease-free survival, while significant predictor of overall survival were more than four lymph node metastases (P = 0.0011), bilobar disease (P = 0.0024), and increase in perioperative monocyte less than twice (P = 0.0029). Morover, increase in perioperative monocyte of less than twice positively correlated with intraoperative blood transfusion.

CONCLUSIONS

Perioperative change in peripheral blood monocyte count is an independent risk factor for overall survival after hepatic resection for CRLM, and may reflect immunosuppressive state.

摘要

背景

癌症患者围手术期外周血白细胞亚群计数的变化的预后价值尚未得到充分研究。因此,我们回顾性研究了结直肠癌肝转移(CRLM)患者肝切除术后外周血单核细胞计数的变化与无病生存率和总生存率之间的关系。

方法

本研究对象为 2000 年 1 月至 2008 年 12 月期间接受肝切除术治疗的 64 例 CRLM 患者。我们回顾性研究了外周血单核细胞计数的围手术期变化与无病生存率和总生存率之间的关系。

结果

多因素分析显示,淋巴结转移数大于 4 个(P = 0.0298)和肝外疾病(P = 0.0423)是无病生存率的显著预测因素,而淋巴结转移数大于 4 个(P = 0.0011)、双叶病变(P = 0.0024)和围手术期单核细胞增加小于两倍(P = 0.0029)是总生存率的显著预测因素。此外,围手术期单核细胞增加小于两倍与术中输血呈正相关。

结论

CRLM 患者肝切除术后外周血单核细胞计数的变化是总生存率的独立危险因素,可能反映了免疫抑制状态。

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