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高平均红细胞体积作为接受同步放化疗的食管癌患者总生存期较差的预测指标

High Mean Corpuscular Volume as a Predictor of Poor Overall Survival in Patients with Esophageal Cancer Receiving Concurrent Chemoradiotherapy.

作者信息

Li Ke-Jie, Gu Wen-Yue, Xia Xiao-Fang, Zhang Ping, Zou Chang-Lin, Fei Zheng-Hua

机构信息

Department of Radiation Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.

Department of Pathology, Yancheng Hospital Affiliated of Southeast University, Yancheng, Jiangsu 224000, People's Republic of China.

出版信息

Cancer Manag Res. 2020 Aug 20;12:7467-7474. doi: 10.2147/CMAR.S230274. eCollection 2020.

Abstract

BACKGROUND

Increasing numbers of recent studies have demonstrated that high mean corpuscular volume (MCV) is a predictor of poor overall survival (OS) and therapeutic response in patients with solid tumors. The aim of the present study was to explore the association between high MCV and OS in patients with advanced esophageal cancer (EC) undergoing concurrent chemoradiotherapy.

PATIENTS AND METHODS

Enrolled in this study were 249 patients with advanced EC who underwent concurrent chemoradiotherapy. Pre-treatment MCV values were collected in all patients and their correlations with OS and pathophysiological characteristics were analyzed. The chi-square test was used to explore the correlation between MCV and various clinical pathophysiological characteristics, and the prognostic significance of high MCV using Kaplan-Meier curves and the Cox proportional hazards model. All -values were two-tailed and a -value <0.05 was considered statistically significant.

RESULTS

According to ROC curve analysis, the optimal cut-off value of MCV was 93.6 fL. The mean OS was 14.7 months in all 249 EC patients, 10.9 months in patients with MCV >93.6 fL, and 18.8 months in patients with MCV <93.6 fL; the difference is statistically significant (P<0.05). Chi-square test showed that the MCV value was correlated with the N stage of the tumor and the therapeutic effect, indicating that the higher the MCV was, the higher the T stage of the tumor and the worse the therapeutic effect would be (p=0.012 and p <0.01). Multivariate analysis showed that MCV (OR = 1.864, 95% CI: 1.439-2.415) was an independent prognostic factor for OS in EC patients.

CONCLUSION

High MCV is a poor predictor of OS in patients with advanced EC receiving concurrent chemoradiotherapy.

摘要

背景

近年来越来越多的研究表明,高平均红细胞体积(MCV)是实体瘤患者总生存期(OS)和治疗反应较差的一个预测指标。本研究的目的是探讨高MCV与接受同步放化疗的晚期食管癌(EC)患者OS之间的关联。

患者与方法

本研究纳入了249例接受同步放化疗的晚期EC患者。收集所有患者治疗前的MCV值,并分析其与OS及病理生理特征的相关性。采用卡方检验探讨MCV与各种临床病理生理特征之间的相关性,并使用Kaplan-Meier曲线和Cox比例风险模型分析高MCV的预后意义。所有P值均为双侧,P值<0.05被认为具有统计学意义。

结果

根据ROC曲线分析,MCV的最佳截断值为93.6 fL。249例EC患者的平均OS为14.7个月,MCV>93.6 fL的患者为10.9个月,MCV<93.6 fL的患者为18.8个月;差异具有统计学意义(P<0.05)。卡方检验显示,MCV值与肿瘤的N分期及治疗效果相关,表明MCV越高,肿瘤的T分期越高,治疗效果越差(P=0.012和P<0.01)。多因素分析显示,MCV(OR = 1.864,95%CI:1.439-2.415)是EC患者OS的独立预后因素。

结论

高MCV是接受同步放化疗的晚期EC患者OS的不良预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ea/7445527/6ddcd188579a/CMAR-12-7467-g0001.jpg

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