Virdee Pradeep S, Patnick Julietta, Watkinson Peter, Birks Jacqueline, Holt Tim A
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK.
Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK.
NIHR Open Res. 2022 Oct 18;2:32. doi: 10.3310/nihropenres.13266.2. eCollection 2022.
The full blood count (FBC) is a common blood test performed in general practice. It consists of many individual parameters that may change over time due to colorectal cancer. Such changes are likely missed in practice. We identified trends in these FBC parameters to facilitate early detection of colorectal cancer.
We performed a retrospective, case-control, longitudinal analysis of UK primary care patient data. LOWESS smoothing and mixed effects models were derived to compare trends in each FBC parameter between patients diagnosed and not diagnosed over a prior 10-year period.
There were 399,405 males (2.3%, n = 9,255 diagnosed) and 540,544 females (1.5%, n = 8,153 diagnosed) in the study. There was no difference between cases and controls in FBC trends between 10 and four years before diagnosis. Within four years of diagnosis, trends in many FBC levels statistically significantly differed between cases and controls, including red blood cell count, haemoglobin, white blood cell count, and platelets (interaction between time and colorectal cancer presence: p <0.05). FBC trends were similar between Duke's Stage A and D colorectal tumours, but started around one year earlier in Stage D diagnoses.
Trends in FBC parameters are different between patients with and without colorectal cancer for up to four years prior to diagnosis. Such trends could help earlier identification.
全血细胞计数（FBC）是全科医疗中常见的一项血液检查。它包含许多个体参数，这些参数可能会因结直肠癌而随时间发生变化。在实际操作中，此类变化很可能被忽视。我们确定了这些FBC参数的趋势，以促进结直肠癌的早期检测。
我们对英国初级医疗患者数据进行了一项回顾性、病例对照纵向分析。采用局部加权散点平滑法（LOWESS）平滑和混合效应模型，比较在过去10年中已确诊和未确诊患者的每个FBC参数的趋势。
研究中有399,405名男性（2.3%，n = 9,255例确诊）和540,544名女性（1.5%，n = 8,153例确诊）。在诊断前10年至4年期间，病例组和对照组的FBC趋势没有差异。在诊断后的4年内，许多FBC水平的趋势在病例组和对照组之间存在统计学显著差异，包括红细胞计数、血红蛋白、白细胞计数和血小板（时间与结直肠癌存在之间的交互作用：p <0.05）。杜克分期A期和D期的结直肠肿瘤的FBC趋势相似，但D期诊断的趋势开始时间比A期早约一年。
在诊断前长达4年的时间里，结直肠癌患者和非结直肠癌患者的FBC参数趋势不同。此类趋势有助于更早地识别。
