[血小板计数对接受辅助化疗的II-III期结直肠癌预后的影响]

[Impact of platelet count on prognosis of stage II-III colorectal cancer receiving adjuvant chemotherapy].

作者信息

Wei Yisheng, Liang Zhihua, Hong Chuyuan, Luo Diteng, Cai Zizhi, Guan Huajie, Zeng Zicheng, Yang Ziyun, Luo Pan, Tan Zeyu

机构信息

Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2015 Dec;18(12):1261-4.

PMID:26704012

Abstract

OBJECTIVE

To analyze the impact of platelet count on the prognosis of stage II-III colorectal cancer receiving adjuvant chemotherapy.

METHODS

Clinical and follow-up data of 286 patients with stage II-III colorectal cancer receiving adjuvant FOLFOX chemotherapy from March 2003 to October 2011 were analyzed retrospectively. Associations of baseline blood platelet count before chemotherapy and nadir blood platelet count during chemotherapy with relapse and death after adjuvant chemotherapy were analyzed by ROC curve and the optimal cutoff was selected. The association of the blood platelet count and the prognosis was analyzed by Kaplan-Meier and Cox regression model.

RESULTS

ROC curve showed the baseline blood platelet count was associated with recurrence (AUC=0.588, P=0.034). The optimal cutoff affecting recurrence was 276×10(9)/L. Kaplan-Meier showed those with baseline platelet count >276×10(9)/L receiving adjuvant chemotherapy had worse disease free survival (DFS) than those with baseline platelet count ≤276×10(9)/L, whose 5-year disease free survival(DFS) was 66% and 80% respectively (P=0.013). Cox regression analysis revealed baseline platelet count >276×10(9)/L was an independent unfavorable factor for DFS of adjuvant chemotherapy in colorectal cancer (HR=1.865, 95% CI: 1.108-3.141, P=0.019).

CONCLUSION

Colorectal cancer patients receiving adjuvant chemotherapy with baseline platelet count >276×10(9)/L have worse prognosis.

摘要

目的

分析血小板计数对接受辅助化疗的II - III期结直肠癌患者预后的影响。

方法

回顾性分析2003年3月至2011年10月期间接受FOLFOX辅助化疗的286例II - III期结直肠癌患者的临床及随访资料。通过ROC曲线分析化疗前基线血小板计数和化疗期间最低血小板计数与辅助化疗后复发及死亡的相关性，并选择最佳截断值。采用Kaplan - Meier法和Cox回归模型分析血小板计数与预后的相关性。

结果

ROC曲线显示基线血小板计数与复发相关（AUC = 0.588，P = 0.034）。影响复发的最佳截断值为276×10⁹/L。Kaplan - Meier法显示，接受辅助化疗且基线血小板计数>276×10⁹/L的患者无病生存期（DFS）较基线血小板计数≤276×10⁹/L的患者差，其5年无病生存率分别为66%和80%（P = 0.013）。Cox回归分析显示，基线血小板计数>276×10⁹/L是结直肠癌辅助化疗DFS的独立不良因素（HR = 1.865，95%CI：1.108 - 3.141，P = 0.019）。