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循环嗜碱性粒细胞计数作为结直肠癌肿瘤侵袭性和生存结果的预后标志物。

Circulating basophil count as a prognostic marker of tumor aggressiveness and survival outcomes in colorectal cancer.

作者信息

Liu Qi, Luo Dakui, Cai Sanjun, Li Qingguo, Li Xinxiang

机构信息

Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, #270 Dongan Road, Xuhui District, Shanghai, 200032, China.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

Clin Transl Med. 2020 Feb 10;9(1):6. doi: 10.1186/s40169-019-0255-4.

Abstract

BACKGROUND

Accumulating evidence demonstrated immune/inflammation-related implications of basophils in affecting tissue microenvironment that surrounded a tumor, and this study aimed to elucidate the clinical value of serum basophil count level.

METHODS

Between December 2007 and September 2013, 1029 patients diagnosed with stage I-III CRC in Fudan University Shanghai Cancer Center meeting the essential criteria were identified. The Kaplan-Meier method was used to construct the survival curves. Several Cox proportional hazard models were constructed to assess the prognostic factors. A simple predictor (CB classifier) was generated by combining serum basophil count and serum carcinoembryonic antigen (CEA) level which had long been accepted as the most important and reliable prognostic factor in CRC.

RESULTS

The preoperative basophils count < 0.025*10/L was strongly associated with higher T stage, higher N stage, venous invasion, perineural invasion, elevated serum CEA level, and thus poor survival (P < 0.05). Moreover, multivariate Cox analysis showed that patients with low level of preoperative basophils count had an evidently poorer DFS [Hazard ratio (HR) = 2.197, 95% CI 1.868-2.585].

CONCLUSIONS

As a common immune/inflammation-related biomarker available from the blood routine examination, low level of preoperative serum basophil count was associated with aggressive biology and indicated evidently poor survival. Preoperative serum basophil count would be a useful and simple marker for the management of CRC patients.

摘要

背景

越来越多的证据表明嗜碱性粒细胞在影响肿瘤周围组织微环境方面具有免疫/炎症相关作用,本研究旨在阐明血清嗜碱性粒细胞计数水平的临床价值。

方法

2007年12月至2013年9月期间,在复旦大学附属上海肿瘤医院确诊为I - III期结直肠癌且符合基本标准的1029例患者被纳入研究。采用Kaplan - Meier法绘制生存曲线。构建多个Cox比例风险模型以评估预后因素。通过结合血清嗜碱性粒细胞计数和血清癌胚抗原(CEA)水平生成一个简单的预测指标(CB分类器),CEA长期以来一直被认为是结直肠癌最重要且可靠的预后因素。

结果

术前嗜碱性粒细胞计数<0.025×10⁹/L与更高的T分期、更高的N分期、静脉侵犯、神经侵犯、血清CEA水平升高显著相关,因此生存率较低(P<0.05)。此外,多因素Cox分析显示术前嗜碱性粒细胞计数水平低的患者无病生存期明显更差[风险比(HR)=2.197,95%可信区间1.868 - 2.585]。

结论

作为血常规检查中常用的免疫/炎症相关生物标志物,术前血清嗜碱性粒细胞计数水平低与侵袭性生物学行为相关,且生存率明显较差。术前血清嗜碱性粒细胞计数将是管理结直肠癌患者的一个有用且简单的标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/7008108/35221970f449/40169_2019_255_Fig1_HTML.jpg

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