术前平均红细胞体积在II/III期结直肠癌合并贫血患者中的意义

Significance of preoperative mean corpuscular volume in patients with stage II/III colorectal cancer and anemia.

作者信息

Asai Shuhei, Miyake Hideo, Nagai Hidemasa, Yoshioka Yuichiro, Shibata Koji, Takamizawa Junichi, Yuasa Norihiro

机构信息

Department of Gastrointestinal Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-Cho, Nakamura-Ku, Nagoya, 453-8511, Japan.

Department of Laboratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-Cho, Nakamura-Ku, Nagoya, 453-8511, Japan.

出版信息

Int J Clin Oncol. 2025 Apr 25. doi: 10.1007/s10147-025-02765-7.

DOI:10.1007/s10147-025-02765-7

PMID:40281352

Abstract

BACKGROUND

Several studies have examined the relationship between mean corpuscular volume (MCV) and prognosis of patients with colorectal cancer (CRC); however, these findings have been inconsistent. This study aimed to investigate the association between the preoperative MCV and recurrence-free survival (RFS) in patients with CRC.

METHODS

We analyzed 1876 patients with stage II/III CRC who underwent R0 resection. The relationships between clinicopathological factors and RFS were investigated using univariate and multivariate analyses. The prognostic significance of the MCV was examined in various clinicopathological contexts. Anemia was defined as Hb < 13 g/dL in men and Hb < 12 g/dL in women.

RESULTS

The mean patient age was 69 ± 11 years. The 5-year RFS rate was 73.3%. Multivariate analysis showed that tumor location, histological grade, stage, serum carcinoembryonic antigen level, carbohydrate antigen 19-9, neutrophil/lymphocyte ratio, and MCV were significant independent risk factors for RFS. Hazard ratios for recurrence were 0.60 for MCV < 80 fL and 1.76 for MCV ≥ 100 fL, compared to MCV 80-100 fL (p < 0.033). The 5-year RFS rates were 83.4% and 58.9%, respectively. This trend was more pronounced in patients with anemia and was contradictory in those without anemia.

CONCLUSION

MCV < 80 fL and ≥ 100 fL can be an indicator of favorable and worse RFS, respectively, in patients with stage II/III CRC and anemia.

摘要

背景

多项研究探讨了平均红细胞体积（MCV）与结直肠癌（CRC）患者预后之间的关系；然而，这些研究结果并不一致。本研究旨在调查CRC患者术前MCV与无复发生存期（RFS）之间的关联。

方法

我们分析了1876例接受R0切除的II/III期CRC患者。采用单因素和多因素分析研究临床病理因素与RFS之间的关系。在各种临床病理背景下检查MCV的预后意义。贫血定义为男性血红蛋白（Hb）<13 g/dL，女性Hb<12 g/dL。

结果

患者平均年龄为69±11岁。5年RFS率为73.3%。多因素分析显示，肿瘤位置、组织学分级、分期、血清癌胚抗原水平、糖类抗原19-9、中性粒细胞/淋巴细胞比值和MCV是RFS的显著独立危险因素。与MCV 80-100 fL相比，MCV< 80 fL的复发风险比为0.60，MCV≥100 fL的复发风险比为1.76（p<0.033）。5年RFS率分别为83.4%和58.9%。这种趋势在贫血患者中更为明显，但在非贫血患者中则相反。