Bailey J A, Hanbali N, Premji K, Bunce J, Mashlab S, Simpson J A, Humes D J, Banerjea A
Nottingham Colorectal Service, Nottingham University Hospitals NHS Trust, E Floor West Block, QMC Campus, Nottingham, NG7 2UH, UK.
Department of Clinical Chemistry, City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK.
Int J Colorectal Dis. 2020 Jul;35(7):1347-1350. doi: 10.1007/s00384-020-03597-9. Epub 2020 May 1.
Primary care studies suggest that thrombocytosis (platelet counts > 400 × 10/L) is associated with an increased risk of colorectal cancer (CRC). We aimed to establish whether this marker has significant stratification value in patients seen in secondary care.
A retrospective review of 2991 patients referred to our colorectal 2-week-wait (2WW) pathway between August 2014 and August 2017. Patient demographics were recorded prospectively, and local electronic records systems were used to retrieve full blood counts (FBC) and cancer diagnoses. Patients with no recent platelet count at the time of referral or incomplete records were excluded.
2236 patients were included in this evaluation. There was no significant difference in the age distribution of those with thrombocytosis and those without. There were significantly more females in the thrombocytosis group (72.1% vs 53.9%, chi-squared 24.63, p < 0.0001). 130 CRCs were detected (5.8%) and patients with thrombocytosis were more likely to have CRC (OR 2.62, 95% CI 1.60-4.30). The CRC diagnosis rate was significantly higher in females with thrombocytosis (10.3% vs 2.9%, chi-squared 19.41, p < 0.0001) and males with thrombocytosis (16.1% vs 7.9%, chi-squared 4.62, p = 0.032).
Thrombocytosis appears to have stratification value in the 2WW population. Further evaluation of its value alone or in combination with other stratification tests is required.
基层医疗研究表明，血小板增多症（血小板计数>400×10⁹/L）与结直肠癌（CRC）风险增加相关。我们旨在确定该标志物在二级医疗中的患者是否具有显著的分层价值。
对2014年8月至2017年8月转诊至我们结直肠两周等待（2WW）路径的2991例患者进行回顾性研究。前瞻性记录患者人口统计学资料，并使用当地电子记录系统检索全血细胞计数（FBC）和癌症诊断信息。排除转诊时无近期血小板计数或记录不完整的患者。
本评估纳入2236例患者。血小板增多症患者和非血小板增多症患者的年龄分布无显著差异。血小板增多症组女性明显更多（72.1%对53.9%，卡方值24.63，p<0.0001）。检测到130例结直肠癌（5.8%），血小板增多症患者患结直肠癌的可能性更大（比值比2.62，95%置信区间1.60 - 4.30）。血小板增多症女性的结直肠癌诊断率显著更高（10.3%对2.9%，卡方值19.41，p<0.0001），血小板增多症男性的诊断率也更高（16.1%对7.9%，卡方值4.62，p = 0.032）。
血小板增多症在2WW人群中似乎具有分层价值。需要进一步评估其单独或与其他分层检测联合的价值。
