Liu Qi, Yang Yufei, Li Xinxiang, Zhang Sheng
Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Front Oncol. 2021 Jun 14;11:681406. doi: 10.3389/fonc.2021.681406. eCollection 2021.
To elucidate the prognostic significance of mean corpuscular volume (MCV), with implications of habitual alcohol intake in stage II-III colorectal cancer (CRC).
MCV had the potential to become an ideal prognostic biomarker and be put into clinical application. Few studies, however, have explored whether habitual alcohol intake which greatly increased the value of MCV would affect the prognostic role of MCV.
Eligible patients were identified from the CRC database of Fudan University Shanghai Cancer Center (FUSCC) between January 2012 and December 2013. Survival analyses were constructed using the Kaplan-Meier method to evaluate the survival time distribution, and the log-rank test was used to determine the survival differences. Univariate and multivariate Cox proportional hazard models were built to calculate the hazard ratios of different prognostic factors.
A total of 694 patients diagnosed with stage II-III CRC between January 2012 and December 2013 were identified from FUSCC. Low pretreatment MCV was independently associated with 72.0% increased risk of overall mortality compared with normal MCV (HR = 1.720, 95%CI =1.028-2.876, P =0.039, using normal MCV as the reference). In patients with habitual alcohol intake, however, pretreatment MCV positively correlated with the mortality (P = 0.02) and tumor recurrence (P = 0.002) after adjusting for other known prognostic factors.
In CRC patients without habitual alcohol intake, low (<80 fL) level of pretreatment MCV was a predictor of poor prognosis. In patients with habitual alcohol intake, however, pretreatment MCV showed the opposite prognostic role, which would elicit many fundamental studies to elucidate the mechanisms behind.
阐明平均红细胞体积（MCV）对II - III期结直肠癌（CRC）的预后意义，以及习惯性饮酒对其的影响。
MCV有潜力成为理想的预后生物标志物并应用于临床。然而，很少有研究探讨大幅升高MCV值的习惯性饮酒是否会影响MCV的预后作用。
从2012年1月至2013年12月复旦大学附属肿瘤医院（FUSCC）的CRC数据库中确定符合条件的患者。采用Kaplan - Meier法构建生存分析以评估生存时间分布，并用对数秩检验确定生存差异。建立单因素和多因素Cox比例风险模型以计算不同预后因素的风险比。
从FUSCC中确定了2012年1月至2013年12月期间诊断为II - III期CRC的694例患者。与正常MCV相比，治疗前低MCV与总死亡率风险增加72.0%独立相关（HR = 1.720，95%CI = 1.028 - 2.876，P = 0.039，以正常MCV为参照）。然而，在习惯性饮酒的患者中，在调整其他已知预后因素后，治疗前MCV与死亡率（P = 0.02）和肿瘤复发（P = 0.002）呈正相关。
在无习惯性饮酒的CRC患者中，治疗前低（<80 fL）水平的MCV是预后不良的预测指标。然而，在习惯性饮酒的患者中，治疗前MCV显示出相反的预后作用，这将引发许多基础研究以阐明其背后的机制。
