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术前血液检查能告诉我们关于结直肠癌的哪些信息?

What can preoperative blood tests tell us about colorectal cancer?

作者信息

Kostakis Ioannis, Vaiopoulos Aristeidis G, Garoufalia Zoe, Papavassiliou Athanasios, Kykalos Stylianos, Kouraklis Gregory, Tsourouflis Gerasimos

机构信息

Second Department of Propaedeutic Surgery, "Laiko" General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

出版信息

J BUON. 2018 Dec;23(7):84-95.

Abstract

PURPOSE

To study the diagnostic and/or prognostic role of preoperative blood tests in colorectal cancer.

METHODS

Preoperative complete blood count tests and lactate dehydrogenase (LDH) serum levels of 167 patients with colorectal adenocarcinoma were examined for associations with clinicopathological parameters, disease-specific survival (DSS) and relapse-free survival (RFS).

RESULTS

The following parameters showed high sensitivity (≥85%) in detecting these features: platelet to lymphocyte ratio (PLR) for T4 tumors, white blood cell count (WBC) and neutrophil count (NC) for distant metastases and lymphocyte count (LC) for high-grade tumors. The following parameters showed high specificity (≥85%) in excluding these features: lymphocyte percentage (LP) for tumors larger than 5 cm, LP, neutrophil to lymphocyte ratio (NLR), neutrophil to monocyte ratio (NMR), lymphocyte to monocyte ratio (LMR) and LDH for T4 tumors, platelet to monocyte ratio (PMR) for T2-T4 tumors, LDH for more than three infiltrated regional lymph nodes and distant metastases, LMR for high-grade tumors and neutrophil percentage (NP) for lymphovascular invasion. WBC and NLR were independent prognostic factors for DSS, whereas WBC, NP, LP and NLR were independent prognostic factors for RFS.

CONCLUSIONS

Preoperative complete blood count and LDH serum levels can provide valuable information about diagnosis and prognosis in colorectal cancer.

摘要

目的

研究术前血液检查在结直肠癌中的诊断和/或预后作用。

方法

对167例结直肠腺癌患者的术前全血细胞计数检查和乳酸脱氢酶(LDH)血清水平进行检测,以探讨其与临床病理参数、疾病特异性生存(DSS)和无复发生存(RFS)的相关性。

结果

以下参数在检测这些特征时显示出高敏感性(≥85%):T4肿瘤的血小板与淋巴细胞比值(PLR)、远处转移的白细胞计数(WBC)和中性粒细胞计数(NC)以及高级别肿瘤的淋巴细胞计数(LC)。以下参数在排除这些特征时显示出高特异性(≥85%):肿瘤大于5 cm时的淋巴细胞百分比(LP)、T4肿瘤的LP、中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞与单核细胞比值(NMR)、淋巴细胞与单核细胞比值(LMR)和LDH、T2 - T4肿瘤的血小板与单核细胞比值(PMR)、超过三个区域淋巴结浸润和远处转移时的LDH、高级别肿瘤的LMR以及淋巴管侵犯时的中性粒细胞百分比(NP)。WBC和NLR是DSS的独立预后因素,而WBC、NP、LP和NLR是RFS的独立预后因素。

结论

术前全血细胞计数和LDH血清水平可为结直肠癌的诊断和预后提供有价值的信息。

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