Admasu Fitalew Tadele, Dejenie Tadesse Asmamaw, Ayehu Gashaw Walle, Zewde Edget Abebe, Dessie Gashaw, Adugna Dagnew Getnet, Enyew Engidaw Fentahun, Geto Zeleke, Abebe Endeshaw Chekol
Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Biochemistry, School of Medicine, College of Health Sciences and Medicine, Gondar University, Gondar, Ethiopia.
Front Oncol. 2023 May 2;13:1143122. doi: 10.3389/fonc.2023.1143122. eCollection 2023.
Patients with colorectal cancer are at an increased risk of hemostatic disturbances, and recent studies have shown that coagulation disorders could be the first sign of malignancy. Although coagulopathy is a significant cause of cancer-related death and disability, it is usually underestimated, and there has been no recent scientific evidence regarding the exact burden and its specific determinants. Moreover, the public health importance of the risk of coagulopathy among patients with colorectal polyps has not been addressed.
An institution-based comparative cross-sectional study was conducted on a total of 500 study participants (250 colorectal cancer patients, 150 colorectal polyp patients, and 100 controls) from January to December 2022. Venous blood was collected for basic coagulation and platelet analysis. Descriptive statistics and non-parametric tests (Kruskal-Wallis and Dunn-Bonferroni pairwise comparisons) were used to compare study parameters among the groups. The test results were expressed as medians and interquartile ranges. Binary logistic regressions were fitted, and statistical significance was declared at a -value of less than 0.05, with 95% CI.
The prevalence of coagulopathy among colorectal cancer patients was 198 (79.2%; 95% CI: 73.86, 83.64), while the prevalence was 76 (50.7%; 95% CI: 45.66, 54.34) among colorectal polyp patients. From the final model, age between 61 and 70 (AOR = 3.13: 95% CI: 1.03, 6.94), age > 70 years (AOR = 2.73: 95% CI: 1.08, 4.71), hypertension (AOR = 6.8: 95% CI: 1.07, 14.1), larger tumor size (AOR = 3.31: 95% CI: 1.11, 6.74), metastatic cancer (AOR = 5.8: 95% CI: 1.1, 14.7), and BMI ≥30 kg/m (AOR = 3.8: 95% CI: 2.3, 4.8) were positively associated with coagulopathy.
This study showed that coagulopathy is a major public health concern among patients with colorectal cancer. Therefore, existing oncology care efforts should be strengthened to prevent coagulopathy among patients with colorectal cancer. Moreover, patients with colorectal polyps should receive more attention.
结直肠癌患者发生止血障碍的风险增加，最近的研究表明凝血障碍可能是恶性肿瘤的首个迹象。尽管凝血病是癌症相关死亡和残疾的重要原因，但通常被低估，并且最近没有关于其确切负担及其具体决定因素的科学证据。此外，结直肠息肉患者发生凝血病风险的公共卫生重要性尚未得到探讨。
2022年1月至12月，对总共500名研究参与者（250名结直肠癌患者、150名结直肠息肉患者和100名对照）进行了一项基于机构的比较横断面研究。采集静脉血进行基本凝血和血小板分析。使用描述性统计和非参数检验（Kruskal-Wallis检验和Dunn-Bonferroni两两比较）来比较各组之间的研究参数。测试结果以中位数和四分位间距表示。进行二元逻辑回归分析，当P值小于0.05且95%置信区间时判定具有统计学意义。
结直肠癌患者中凝血病的患病率为198例（79.2%；95%置信区间：73.86，83.64），而结直肠息肉患者中的患病率为76例（50.7%；95%置信区间：45.66，54.34）。在最终模型中，61至70岁（比值比=3.13：95%置信区间：1.03，6.94）、年龄>70岁（比值比=2.73：95%置信区间：1.08，4.71）、高血压（比值比=6.8：95%置信区间：1.07，14.1）、肿瘤体积较大（比值比=3.31：95%置信区间：1.11，6.74）、转移性癌症（比值比=5.8：95%置信区间：1.1，14.7）以及体重指数≥30kg/m²（比值比=3.8：95%置信区间：2.3，4.8）与凝血病呈正相关。
本研究表明凝血病是结直肠癌患者中的一个主要公共卫生问题。因此，应加强现有的肿瘤护理工作，以预防结直肠癌患者发生凝血病。此外，结直肠息肉患者应受到更多关注。
