Jósa Valéria, Brodszky Valentin, Zaránd Attila, Mezei Tünde, Szilasi Zsuzsanna, Merkel Keresztély, Fehér Adrienne, Szállási Zoltán, Baranyai Zsolt
Department of Otorhinolaryngology and Head and Neck Surgery, Flór Ferenc Hospital, Kistarcsa, Hungary.
Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
Prz Gastroenterol. 2020;15(3):215-219. doi: 10.5114/pg.2020.98538. Epub 2020 Sep 19.
Several reports have stated that thrombocytosis is associated with worse survival and higher rate of metastasis in solid tumours. A study in ovarian tumours implicated IL-6 produced by tumour cells as a key mechanistic factor.
To evaluate the relevance of this paraneoplastic pathway in gastrointestinal cancer.
After excluding thromboembolic and inflammatory disorders, 161 patients were enrolled who had been operated due to various gastrointestinal cancer at the 1 Department of Surgery at the Semmelweis University between 2015 and 2017. Platelet counts and serum IL-6 levels were determined from preoperative blood samples. Thrombocytosis was defined as the upper limit of normal platelet count, e.g. 400 × 10/µl.
A weak but significantly positive correlation was found between elevated platelet counts and serum IL-6 (correlation coefficient: = 0.214, = 0.006), which became more pronounced in colon and oesophageal cancer if evaluated in the different tumour types ( = 0.292 and = 0.419, respectively). However, using a multivariant linear regression model ( = 0.47) corrected with haemoglobin, white blood cell count, and advanced disease stage, the analysis showed no significant correlation between serum IL-6 and platelet counts.
In gastrointestinal cancer our study did not support the paracrine-mediated paraneoplastic pathway described in ovarian tumors. Thrombocytosis showed significant correlation with white blood cells instead of serum IL-6, which implies that the inflammatory process may influence both parameters. Further studies are needed on larger patient cohorts.
多项报告指出，血小板增多症与实体瘤患者较差的生存率及较高的转移率相关。一项针对卵巢肿瘤的研究表明，肿瘤细胞产生的白细胞介素-6（IL-6）是关键的机制性因素。
评估这种副肿瘤途径在胃肠道癌中的相关性。
排除血栓栓塞性和炎性疾病后，纳入了2015年至2017年间在塞梅尔维斯大学第一外科因各种胃肠道癌接受手术的161例患者。术前采集血样测定血小板计数和血清IL-6水平。血小板增多症定义为血小板计数正常上限，如400×10⁹/µl。
血小板计数升高与血清IL-6之间存在微弱但显著的正相关（相关系数：r = 0.214，P = 0.006），按不同肿瘤类型评估时，在结肠癌和食管癌中这种相关性更为明显（分别为r = 0.292和r = 0.419）。然而，使用校正了血红蛋白、白细胞计数和疾病晚期的多变量线性回归模型（r² = 0.47）分析显示，血清IL-6与血小板计数之间无显著相关性。
在胃肠道癌中，我们的研究不支持卵巢肿瘤中描述的旁分泌介导的副肿瘤途径。血小板增多症与白细胞而非血清IL-6显著相关，这意味着炎症过程可能影响这两个参数。需要对更大的患者队列进行进一步研究。
