Inanc Mevlude, Duran Ayse Ocak, Karaca Halit, Berk Veli, Bozkurt Oktay, Ozaslan Ersin, Ozkan Metin
Kayseri Training and Research Hospital, Kayseri, Turkey E-mail :
Asian Pac J Cancer Prev. 2014;15(1):253-6. doi: 10.7314/apjcp.2014.15.1.253.
The standard treatment in the metastatic colorectal cancer consists of 5-FU based infusional regimens. However, with oral fluoropyrimidines, equal tumor responses may be obtained. Capecitabine causes macrocytosis of the cells by inhibition of DNA synthesis. In this context, a relationship was found between mean corpuscular volume (MCV) and response to therapy in breast cancer patients treated with Capecitabine, but whether this relationship also pertains in colorectal cancer has not been established.
A total of 102 metastatic colorectal cancer patients treated with a oxaliplatin (XELOX) ±Bevacizumab combination were retrospectively evaluated. Patients were randomized into three groups. Hematological parameters (MCV, MPV, PCT, PLT, NLR) were recorded retrospectively, before treatment and after 3 cycles of chemotherapy.
After three cycles of therapy, 20 (19.6%) patients had progressive disease (PD), 41 (40.1%) had stable disease (SD), and 41 (40.1%) demonstrated a partial response (PR). In 62 (60.7%) treatment was with capesitabin plus XELOX therapy, and in 40 (39.2%) it was XELOX-Bevacizumab combination therapy. There was no difference among three groups before the treatment in terms of MCV, MPV, PCT, PLT, and NLR. MCV showed significant increase in chemotherapy response groups (PR and SD). In addition, a significant decrease was observed for platelet count in chemotherapy response groups. While NLR decrease was seen in only a PR group, PCT decrease was observed in all three groups. PCT and PLT values were higher in patients receiving Bevacizumab.
PLT, PCT, MPV, and NLR values were decreased due to Capecitabine- based chemotherapy, however MCV was increased. PCT and PLT values were higher in patients who received Bevacizumab than those who did not. MCV, PLT, and NLR can be considered as important factors in predicting response to colorectal carcinoma treatment.
转移性结直肠癌的标准治疗包括基于5-氟尿嘧啶的输注方案。然而，使用口服氟嘧啶也可获得相同的肿瘤反应。卡培他滨通过抑制DNA合成导致细胞大细胞性变。在此背景下，在接受卡培他滨治疗的乳腺癌患者中发现平均红细胞体积（MCV）与治疗反应之间存在关联，但这种关系在结直肠癌中是否也成立尚未明确。
对102例接受奥沙利铂（XELOX）±贝伐单抗联合治疗的转移性结直肠癌患者进行回顾性评估。患者被随机分为三组。回顾性记录治疗前及化疗3个周期后的血液学参数（MCV、MPV、PCT、PLT、NLR）。
三个周期的治疗后，20例（19.6%）患者疾病进展（PD），41例（40.1%）疾病稳定（SD），41例（40.1%）显示部分缓解（PR）。62例（60.7%）采用卡培他滨加XELOX治疗，40例（39.2%）采用XELOX - 贝伐单抗联合治疗。治疗前三组在MCV、MPV、PCT、PLT和NLR方面无差异。化疗反应组（PR和SD）的MCV显著升高。此外，化疗反应组的血小板计数显著降低。虽然仅PR组的NLR降低，但所有三组均观察到PCT降低。接受贝伐单抗治疗的患者的PCT和PLT值更高。
基于卡培他滨的化疗使PLT、PCT、MPV和NLR值降低，但MCV升高。接受贝伐单抗治疗的患者的PCT和PLT值高于未接受者。MCV、PLT和NLR可被视为预测结直肠癌治疗反应的重要因素。
