Kawano Mahiru, Mabuchi Seiji, Matsumoto Yuri, Sasano Tomoyuki, Takahashi Ryoko, Kuroda Hiromasa, Kozasa Katsumi, Isohashi Fumiaki, Ogawa Kazuhiko, Kimura Tadashi
Departments of *Obstetrics and Gynecology, and †Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Int J Gynecol Cancer. 2015 Nov;25(9):1656-62. doi: 10.1097/IGC.0000000000000533.
The aim of this study was to investigate the prevalence and prognostic significance of an elevated platelet count at the time of the initial diagnosis in patients with cervical cancer who are treated with definitive radiotherapy.
The baseline characteristics and outcome data of cervical cancer patients who were treated with definitive radiotherapy between November 1993 and December 2011 were collected and retrospectively reviewed. The patients were separated into 2 groups according to their platelet counts. The clinicopathological characteristics and overall survival rates of the 2 groups were compared. A Cox proportional hazards regression model was used to investigate the prognostic significance of an elevated platelet count.
An elevated platelet count was found to be associated with younger age (P = 0.0003), an advanced clinical stage (P < 0.0001), larger tumors (P = 0.0025), lower hemoglobin levels (P < 0.0001), and more frequent treatment failure (P = 0.0015). Multivariate analysis demonstrated that an advanced clinical stage (hazards ratio [HR], 2.93; 95% confidence interval [CI], 1.47-6.70; P = 0.0015), nonsquamous cell carcinoma histology (HR, 2.67; 95% CI, 1.52-4.42; P = 0.0011), larger tumors (HR, 3.86; 95% CI, 2.18-7.03; P < 0.0001), lower hemoglobin levels (HR, 1.99; 95% CI, 1.34-2.93; P = 0.0008), and an elevated platelet count (HR, 1.65; 95% CI, 1.03-2.56; P = 0.0395) were significant predictors of survival.
An elevated platelet count at the time of the initial diagnosis is an independent prognostic factor in cervical cancer patients who are treated with definitive radiotherapy.
本研究旨在调查接受根治性放疗的宫颈癌患者初次诊断时血小板计数升高的发生率及其预后意义。
收集并回顾性分析1993年11月至2011年12月期间接受根治性放疗的宫颈癌患者的基线特征和结局数据。根据血小板计数将患者分为两组。比较两组的临床病理特征和总生存率。采用Cox比例风险回归模型研究血小板计数升高的预后意义。
发现血小板计数升高与年龄较小（P = 0.0003）、临床分期较晚（P < 0.0001）、肿瘤较大（P = 0.0025）、血红蛋白水平较低（P < 0.0001）以及治疗失败更频繁（P = 0.0015）相关。多因素分析表明，临床分期较晚（风险比[HR]，2.93；95%置信区间[CI]，1.47 - 6.70；P = 0.0015）、非鳞状细胞癌组织学类型（HR，2.67；95% CI，1.52 - 4.42；P = 0.0011）、肿瘤较大（HR，3.86；95% CI，2.18 - 7.03；P < 0.0001）、血红蛋白水平较低（HR，1.99；95% CI，1.34 - 2.93；P = 0.0008）以及血小板计数升高（HR，1.65；95% CI，1.03 - 2.56；P = 0.0395）是生存的重要预测因素。
初次诊断时血小板计数升高是接受根治性放疗的宫颈癌患者的独立预后因素。
