Liu Yuying, Ge Yizhong, Li Qinqin, Ruan Guotian, Zhang Qi, Zhang Xi, Tang Meng, Song Mengmeng, Zhang Xiaowei, Li Xiangrui, Zhang Kangping, Yang Ming, Hu Chunlei, Liu Tong, Xie Hailun, Chen Yongbing, Yu Kaiying, Cong Minghua, Li Wei, Wang Zhengping, Shi Hanping
Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng, Shandong 252000, China.
Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
J Cancer. 2021 Oct 30;12(24):7436-7444. doi: 10.7150/jca.62788. eCollection 2021.
Changes in platelet count (PLT) are strongly associated with patient survival and may be clinically indicative of certain underlying diseases. However, there were few studies on the prognosis of patients with cancer cachexia. The purpose of this study was to investigate the relationship between PLT and 1-year survival in patients with cancer cachexia. We performed a nested case-control study of data from a multicenter clinical study of cancer. There were 252 patients with cancer cachexia whose survival time was less than or equal to 1 year and 252 patients with cancer cachexia whose survival time was more than 1 year meeting the inclusion criteria. The mortality risk and the adjusted risk were estimated by logistic regression and displayed as odds ratios (ORs) and 95% confidence intervals (95% CIs). PLT was negatively correlated with 1-year overall survival (OS) of patients with cancer cachexia (increased per standard deviation (SD): OR = 1.29; 95% CI: 1.05-1.60; = 0.018). The higher the PLT, the lower the OS of patients. When classified by dichotomy (D1 < 296×10/L, D2 ≥ 296×10/L), OS of patients in the D2 group was worse (OR = 2.18; 95% CI: 1.38-3.47; = 0.001). When classified by quartile (Q1- Q3 < 305×10/L, Q4 ≥ 305×10/L), OS of patients in the Q4 group was poorer (OR = 1.82; 95% CI: 1.14-2.94; = 0.013). In addition, patients with a low PLT (< 296×10/L) and either a high total bilirubin (TBIL) (≥ 17.1 µmol/L) or a smoking history had poor 1-year survival. Based on our primary cohort study, we conducted a survival analysis of 3130 patients with cancer cachexia and found that OS was better in patients with low PLT (< 296×10/L). PLT was negatively correlated with 1-year overall survival of patients with cancer cachexia.
血小板计数（PLT）的变化与患者生存率密切相关，且可能在临床上提示某些潜在疾病。然而，关于癌症恶病质患者预后的研究较少。本研究旨在探讨癌症恶病质患者的PLT与1年生存率之间的关系。我们对一项癌症多中心临床研究的数据进行了巢式病例对照研究。有252例生存时间小于或等于1年的癌症恶病质患者以及252例生存时间大于1年的癌症恶病质患者符合纳入标准。通过逻辑回归估计死亡风险和调整风险，并以比值比（OR）和95%置信区间（95%CI）表示。PLT与癌症恶病质患者的1年总生存期（OS）呈负相关（每标准差（SD）增加：OR = 1.29；95%CI：1.05 - 1.60；P = 0.018）。PLT越高，患者的OS越低。按二分法分类（D1 < 296×10⁹/L，D2 ≥ 296×10⁹/L）时，D2组患者的OS更差（OR = 2.18；95%CI：1.38 - 3.47；P = 0.001）。按四分位数分类（Q1 - Q3 < 305×10⁹/L，Q4 ≥ 305×10⁹/L）时，Q4组患者的OS更差（OR = 1.82；95%CI：1.14 - 2.94；P = 0.013）。此外，PLT低（< 296×10⁹/L）且总胆红素（TBIL）高（≥ 17.1 µmol/L）或有吸烟史的患者1年生存率较差。基于我们的主要队列研究，我们对3130例癌症恶病质患者进行了生存分析，发现PLT低（< 296×10⁹/L）的患者OS更好。PLT与癌症恶病质患者的1年总生存期呈负相关。
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