Eo Wan Kyu, Kwon Byung Su, Kim Ki Hyung, Kim Heung Yeol, Kim Hong-Bae, Koh Suk Bong, Chun Sungwook, Ji Yong Il, Lee Ji Young, Namkung Jeong, Kwon Sanghoon
Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.
Department of Obstetrics and Gynecology, Pusan National University School of Medicine; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
J Cancer. 2018 Jan 1;9(1):64-70. doi: 10.7150/jca.22234. eCollection 2018.
To measure hematologic parameters derived from the white blood cell (WBC) count and differential count (DC) as prognostic factors for survival in patients with stage IB and IIA cervical cancer. We retrospectively examined demographic, clinicopathologic, and laboratory parameters in a cohort of 233 patients with International Federation of Gynecology and Obstetrics stage IB and IIA cervical cancer who underwent surgical resection. We further assessed the effects of the WBC count and DC-derived hematologic parameters on progression-free survival (PFS) and overall survival (OS) after controlling for other parameters. Patients were followed up for a median of 46.6 months (range, 9-142 months). The Kaplan-Meier estimates of PFS and OS at 5 years were 88.5% and 92.3%, respectively. In a multivariate analysis, we identified the absolute monocyte count (AMC) (hazard ratio [HR], 11.78; <0.001) and tumor size (HR, 5.41; = 0.003) as the strongest prognostic factors affecting PFS. We also identified AMC (HR, 23.29; <0.001), tumor size, (HR, 5.27; = 0.033), and lymph node involvement (HR, 3.90; = 0.027) as the strongest prognostic factors affecting OS. AMC remained prognostic with respect to PFS or OS in a Cox model that controlled for the neutrophil-lymphocyte ratio or lymphocyte-monocyte ratio, although neither ratio was a significant prognostic factor for survival. Monocytosis and an increased tumor size were found to be independent prognostic factors affecting both PFS and OS in patients with stage IB and IIA cervical cancer.
为了测量从白细胞（WBC）计数和分类计数（DC）得出的血液学参数，将其作为IB期和IIA期宫颈癌患者生存的预后因素。我们回顾性研究了233例接受手术切除的国际妇产科联盟（FIGO）IB期和IIA期宫颈癌患者的人口统计学、临床病理和实验室参数。在控制其他参数后，我们进一步评估了WBC计数和DC衍生的血液学参数对无进展生存期（PFS）和总生存期（OS）的影响。患者的中位随访时间为46.6个月（范围9 - 142个月）。5年时PFS和OS的Kaplan - Meier估计值分别为88.5%和92.3%。在多变量分析中，我们确定绝对单核细胞计数（AMC）（风险比[HR]，11.78；P <0.001）和肿瘤大小（HR，5.41；P = 0.003）是影响PFS的最强预后因素。我们还确定AMC（HR，23.29；P <0.001）、肿瘤大小（HR，5.27；P = 0.033）和淋巴结受累（HR，3.90；P = 0.027）是影响OS的最强预后因素。在控制中性粒细胞 - 淋巴细胞比值或淋巴细胞 - 单核细胞比值的Cox模型中，AMC对于PFS或OS仍然具有预后意义，尽管这两个比值都不是生存的显著预后因素。发现单核细胞增多症和肿瘤大小增加是影响IB期和IIA期宫颈癌患者PFS和OS的独立预后因素。
