Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria.
Section for Medical Statistics (IMS), Center of Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Ann Surg Oncol. 2019 Apr;26(4):976-985. doi: 10.1245/s10434-019-07186-1. Epub 2019 Jan 31.
Elevated mean corpuscular volume (MCV) is associated with a diminished prognosis for various tumor entities. This study aimed to evaluate the association between preoperative serum MCV levels and both overall (OS) and disease-free survival (DFS) for patients with resectable adenocarcinomas of the esophagogastric junction (AEG).
This study included consecutive patients undergoing surgical resection between 1992 and 2016. Measured preoperative MCV levels were stratified into quintiles and correlated with patients' survival and clinicopathologic characteristics.
The study analyzed 314 patients with a median OS of 36.8 months and a median DFS of 20.6 months. The multivariate analysis showed that preoperatively elevated MCV is a significant prognostic factor for OS (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03-1.08; P < 0.001) and DFS (HR, 1.05; 95% CI, 1.03-1.08; P < 0.001). In the subgroup analysis of neoadjuvantly treated and untreated patients, MCV remained an independent prognostic factor for OS (HR, 1.08; 95% CI, 1.04-1.12; P < 0.001) and DFS (HR, 1.07; 95% CI, 1.03-1.12; P < 0.001) in both groups. In the univariate analysis, tumor stage and differentiation, adjuvant chemotherapy, MCV, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly correlated with diminished OS and DFS.
Preoperatively elevated MCV is an independent prognostic factor for patients with adenocarcinomas of the esophagus and the gastroesophageal junction.
平均红细胞体积（MCV）升高与各种肿瘤实体的预后不良有关。本研究旨在评估可切除食管胃结合部腺癌（AEG）患者术前血清 MCV 水平与总生存（OS）和无病生存（DFS）的相关性。
本研究纳入了 1992 年至 2016 年间接受手术切除的连续患者。将测量的术前 MCV 水平分为五组，并与患者的生存和临床病理特征相关联。
本研究分析了 314 例患者，中位 OS 为 36.8 个月，中位 DFS 为 20.6 个月。多变量分析显示，术前 MCV 升高是 OS（风险比 [HR]，1.05；95%置信区间 [CI]，1.03-1.08；P<0.001）和 DFS（HR，1.05；95% CI，1.03-1.08；P<0.001）的显著预后因素。在新辅助治疗和未治疗患者的亚组分析中，MCV 仍然是 OS（HR，1.08；95% CI，1.04-1.12；P<0.001）和 DFS（HR，1.07；95% CI，1.03-1.12；P<0.001）的独立预后因素。在单变量分析中，肿瘤分期和分化、辅助化疗、MCV、平均红细胞血红蛋白（MCH）和平均红细胞血红蛋白浓度（MCHC）与 OS 和 DFS 降低显著相关。
术前 MCV 升高是食管胃结合部腺癌患者的独立预后因素。
