Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740 Jena, Germany.
J Cancer Res Clin Oncol. 2013 Jan;139(1):171-8. doi: 10.1007/s00432-012-1320-1. Epub 2012 Sep 25.
The high comorbidity in patients with head and neck cancer (HNC) is mainly caused by the high incidence of tobacco and alcohol abuse and has direct impact on overall survival. We investigated whether HNC and its comorbidity also influence routine laboratory values and whether these values have influence on overall survival.
A retrospective cohort of 261 patients with primary squamous cell carcinoma of the oral cavity, pharynx, or larynx diagnosed between 2001 and 2006 with a complete set of pretherapeutic laboratory values was identified. The influence of standard oncological parameters, comorbidity, and each laboratory value on overall survival (OS) was investigated in univariate and multivariate analyses.
Two-thirds of patients were active smokers and about one half reported high alcohol consumption. 40 % of patients had severe comorbidity according to Charlson comorbidity index. The most frequent laboratory pathologies were elevated C-reactive protein (CRP) values (66 %), impaired liver enzymes (30-50 %), decreased urea levels (33 %), leukocytosis (20 %), and anemia (10 %). In multivariate analysis for OS, a comorbidity index ≥5 (Hazard ratio [HR], 2.008; 95 % confidence interval [CI], 1.117-3.610; p = 0.020), high CRP level (HR, 2.469; CI, 1.414-4.310; p = 0.001), and abnormal low red-cell count (HR, 2.525; CI, 1.250-5.102; p = 0.010) were independent prognostic variables.
Comorbidity reflected by pathologic laboratory values is a major issue in HNC patients. Several pretherapeutic laboratory values have prognostic relevance for overall survival in HNC patients.
头颈部癌症（HNC）患者的高合并症主要是由烟草和酒精滥用的高发率引起的，这直接影响整体生存率。我们研究了 HNC 及其合并症是否也会影响常规实验室值，以及这些值是否会影响整体生存率。
回顾性分析了 2001 年至 2006 年间诊断为口腔、咽或喉原发性鳞状细胞癌的 261 例患者的队列，这些患者均具有完整的治疗前实验室值。在单变量和多变量分析中，研究了标准肿瘤学参数、合并症以及每个实验室值对总生存率（OS）的影响。
三分之二的患者为活跃吸烟者，约有一半的患者报告有大量饮酒。根据 Charlson 合并症指数，40%的患者患有严重的合并症。最常见的实验室病理包括 C 反应蛋白（CRP）升高（66%）、肝酶异常（30-50%）、尿素水平降低（33%）、白细胞增多（20%）和贫血（10%）。在多变量分析中，OS 的预后因素包括合并症指数≥5（风险比[HR]，2.008；95%置信区间[CI]，1.117-3.610；p=0.020）、高 CRP 水平（HR，2.469；CI，1.414-4.310；p=0.001）和异常低红细胞计数（HR，2.525；CI，1.250-5.102；p=0.010）。
由病理实验室值反映的合并症是 HNC 患者的一个主要问题。几种治疗前的实验室值对 HNC 患者的整体生存率具有预后意义。
