Hernandez E, Heller P B, Whitney C, Diana K, Delgado G
Division of Gynecologic Oncology, Medical College of Pennsylvania, Philadelphia.
Gynecol Oncol. 1994 Dec;55(3 Pt 1):328-32. doi: 10.1006/gyno.1994.1300.
Thrombocytosis has previously been shown to be an unfavorable prognostic factor in cervical cancer patients treated with irradiation. We evaluated the significance of thrombocytosis (platelet count > 400 x 10(9)/liter in 623 surgically treated patients with stage IB squamous cell carcinoma of the cervix. These patients had no gross evidence of extrauterine disease at the time of exploration, and none had metastasis to the para-aortic nodes. Fifty-nine (9.5%) of these 623 patients had thrombocytosis. The 5-year survival for patients with thrombocytosis was 82% compared to 83.5% for patients with normal platelet count (P = 0.4). Pelvic node metastasis was present in 13 (22%) of 59 patients with thrombocytosis, and 77 (13.7%) of 564 patients with normal platelet count (P = 0.1). There was a significant correlation between tumor size and platelet count. Patients with thrombocytosis had a mean tumor size of 27.9 mm, while it was 20.4 mm in patients without thrombocytosis (P = 0.002). Other factors found to be associated with thrombocytosis in this population were elevated white blood cell (WBC) count (P = 0.009) and history of chronic obstructive pulmonary disease (COPD) (P = 0.02). In a multivariate analysis for thrombocytosis adjusted for COPD, WBC count, and tumor size, tumor size continued to be statistically significant (P = 0.01). These data suggest that thrombocytosis is a marker of tumor burden and not an independent prognostic factor for progression-free interval or survival.
血小板增多症先前已被证明是接受放疗的宫颈癌患者的不良预后因素。我们评估了623例接受手术治疗的IB期宫颈鳞状细胞癌患者中血小板增多症（血小板计数>400×10⁹/升）的意义。这些患者在探查时没有宫外疾病的明显证据，也没有主动脉旁淋巴结转移。这623例患者中有59例（9.5%）存在血小板增多症。血小板增多症患者的5年生存率为82%，而血小板计数正常的患者为83.5%（P = 0.4）。59例血小板增多症患者中有13例（22%）存在盆腔淋巴结转移，564例血小板计数正常的患者中有77例（13.7%）存在盆腔淋巴结转移（P = 0.1）。肿瘤大小与血小板计数之间存在显著相关性。血小板增多症患者的平均肿瘤大小为27.9毫米，而无血小板增多症患者为20.4毫米（P = 0.002）。在该人群中发现与血小板增多症相关的其他因素包括白细胞（WBC）计数升高（P = 0.009）和慢性阻塞性肺疾病（COPD）病史（P = 0.02）。在对血小板增多症进行多变量分析时，对COPD、WBC计数和肿瘤大小进行了校正，肿瘤大小仍然具有统计学意义（P = 0.01）。这些数据表明，血小板增多症是肿瘤负荷的一个标志物，而不是无进展生存期或生存率的独立预后因素。
