血液学参数在食管鳞状细胞癌患者食管癌切除术中的预后价值。

Prognostic value of hematological parameters in patients undergoing esophagectomy for esophageal squamous cell carcinoma.

作者信息

Hirahara Noriyuki, Matsubara Takeshi, Kawahara Daisuke, Mizota Yoko, Ishibashi Shuichi, Tajima Yoshitsugu

机构信息

Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.

出版信息

Int J Clin Oncol. 2016 Oct;21(5):909-919. doi: 10.1007/s10147-016-0986-9. Epub 2016 May 6.

Abstract

BACKGROUND

It is now widely recognized that outcomes in cancer patients are not determined by their tumor characteristics alone. In this study, we retrospectively analyzed the clinical data of esophageal cancer patients to evaluate the impact of red blood cell distribution width (RDW), platelet distribution width (PDW), and mean platelet volume (MPV) on cancer-specific survival (CSS).

STUDY DESIGN

We retrospectively reviewed a database of 144 consecutive patients who underwent curative esophagectomy for esophageal squamous cell carcinoma at our institute between 2006 and 2014.

RESULT

In multivariate analysis, pathological stage (pStage) (p = 0.0002) and a high RDW (p = 0.0300) were found to be independently associated with poor survival. Patients with a high RDW had a significantly poorer prognosis in terms of CSS than those with a low RDW (p = 0.004). Among non-elderly patients, multivariate analysis demonstrated that pStage (p = 0.0120), and a high RDW (p = 0.0092) were independent risk factors for a worse prognosis. In addition, non-elderly patients with a high RDW had a significantly poorer prognosis in terms of CSS than those with a low RDW (p = 0.0003). On the other hand, univariate analysis demonstrated that pStage (p = 0.0008) was the only significant risk factor for a poor prognosis in elderly patients.

CONCLUSIONS

We confirmed that a high RDW was significantly associated with the CSS of esophageal cancer patients after curative esophagectomy. Furthermore, in non-elderly patients, a high RDW was a significant and independent predictor of poor survival.

摘要

背景

目前人们普遍认识到,癌症患者的预后并非仅由肿瘤特征决定。在本研究中,我们回顾性分析了食管癌患者的临床数据,以评估红细胞分布宽度(RDW)、血小板分布宽度(PDW)和平均血小板体积(MPV)对癌症特异性生存(CSS)的影响。

研究设计

我们回顾性分析了2006年至2014年期间在我院接受根治性食管切除术的144例连续性食管鳞状细胞癌患者的数据库。

结果

多因素分析发现,病理分期(pStage)(p = 0.0002)和高RDW(p = 0.0300)与生存不良独立相关。高RDW患者的CSS预后明显低于低RDW患者(p = 0.004)。在非老年患者中,多因素分析表明,pStage(p = 0.0120)和高RDW(p = 0.0092)是预后较差的独立危险因素。此外,非老年高RDW患者的CSS预后明显低于低RDW患者(p = 0.0003)。另一方面,单因素分析表明,pStage(p = 0.0008)是老年患者预后不良的唯一显著危险因素。

结论

我们证实,高RDW与根治性食管切除术后食管癌患者的CSS显著相关。此外,在非老年患者中,高RDW是生存不良的重要独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb04/5055579/c851c429e891/10147_2016_986_Fig1_HTML.jpg

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