Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu RD, Jinan, 250021, Shandong, People's Republic of China.
Shandong Center for Diseases Control and Prevention, 16992 Jingshi RD, Jinan, 250014, Shandong, People's Republic of China.
BMC Cancer. 2020 May 13;20(1):414. doi: 10.1186/s12885-020-06881-7.
Anaemia is highly prevalent in gastric cancer (GC) patients. The role of initial haemoglobin levels in predicting the prognosis of GC patients treated by chemotherapy has not been well determined. Our present study aims to evaluate the relationship between the degree of anaemia and the overall survival (OS) and progression-free survival (PFS) of patients with GC.
Our retrospective study enrolled 598 patients who were treated with chemotherapy when the recurrent or metastatic GCs were unsuitable for surgical resection. Univariate and multivariate analyses were performed to identify risk factors that had the potential to affect patient prognosis. Additionally, the relationship between clinicopathological characteristics, including treatment method, and degree of cancer-related reduction in haemoglobin was further analysed.
Our results revealed that patients with HB level ≤ 80 g/L had a trend toward a shortened median OS and PFS (p = 0.009 and p = 0.049, respectively). Interestingly, we also found that HB ≥ 30 g/L was associated with a significantly shortened median OS and PFS (p = 0.039 and p = 0.001, respectively). Multivariate analysis showed that HB levels ≤80 g/L could be used as an independent prognostic factor for recurrent and metastatic GC. More importantly, HB ≥ 30 g/L and treatment response were also significantly associated with OS and PFS. Furthermore, the degree of haemoglobin decrease was associated with chemotherapy including platinum and the number of chemotherapy cycles.
Our study concludes that the initial degree of anaemia and a decrease in haemoglobin of ≥30 g/L can serve as biomarkers to predict prognosis in recurrent or metastatic GC patients, while chemotherapy treatment rather than red blood cell (RBC) transfusion can improve their prognosis. Additionally, platinum should not be recommended for treating severely anaemic GC patients.
贫血在胃癌（GC）患者中很常见。初始血红蛋白水平在预测接受化疗的 GC 患者预后中的作用尚未得到很好的确定。本研究旨在评估贫血程度与 GC 患者的总生存（OS）和无进展生存（PFS）之间的关系。
我们的回顾性研究纳入了 598 名接受化疗治疗的复发性或转移性 GC 患者，这些患者不适合手术切除。进行单因素和多因素分析，以确定有潜在影响患者预后的风险因素。此外，还进一步分析了临床病理特征，包括治疗方法和与癌症相关的血红蛋白降低程度之间的关系。
我们的结果表明，HB 水平≤80g/L 的患者的中位 OS 和 PFS 均缩短（p=0.009 和 p=0.049）。有趣的是，我们还发现 HB≥30g/L 与中位 OS 和 PFS 显著缩短相关（p=0.039 和 p=0.001）。多因素分析表明，HB 水平≤80g/L 可作为复发性和转移性 GC 的独立预后因素。更重要的是，HB≥30g/L 和治疗反应与 OS 和 PFS 也显著相关。此外，血红蛋白下降程度与包括铂类药物在内的化疗以及化疗周期数有关。
本研究表明，初始贫血程度和血红蛋白下降≥30g/L 可作为预测复发性或转移性 GC 患者预后的生物标志物，而化疗治疗而非红细胞（RBC）输血可改善其预后。此外，不建议对严重贫血的 GC 患者使用铂类药物。
