Rodriguez G C, Clarke-Pearson D L, Soper J T, Berchuck A, Synan I, Dodge R K
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
Obstet Gynecol. 1994 Mar;83(3):445-8.
To determine the association between pretreatment platelet count and survival in women with stage IB cervical cancer.
Clinical records were reviewed for 219 women with stage IB cervical cancer treated by radical hysterectomy from 1971-1984. Univariate and multivariate analyses were performed to identify clinicopathologic variables associated with poor survival. Survival as a function of the preoperative platelet count was analyzed further and corrected for known prognostic factors.
The cumulative 5-year survival of women with a preoperative platelet count greater than 300,000/microL (n = 85) was 65%, as compared to 84% for a count equal to or less than 300,000/microL (n = 134) (P = .004). Univariate Cox regression analysis revealed non-white race, large lesion size (greater than 4 cm), platelet count greater than 300,000/microL, and the presence of nodal metastases to be factors related to poor prognosis. A comparison of patients with platelet counts of 300,000/microL or less and patients with platelet counts greater than 300,000/microL revealed no difference with regard to race, nodal metastases, and median age. However, a larger percentage of women with a platelet count greater than 300,000/microL had large lesion size (29 of 60, versus 32 of 114 with a count of 300,000/microL or less). In a multivariate analysis, after adjusting for age, race, the presence of nodal metastases, and lesion size, high platelet count was still associated with poor prognosis (P = .04).
An elevated platelet count is an independent prognostic factor for poor survival in patients with early-stage cervical cancer.
确定IB期宫颈癌女性患者治疗前血小板计数与生存率之间的关联。
回顾了1971年至1984年间接受根治性子宫切除术治疗的219例IB期宫颈癌女性患者的临床记录。进行单因素和多因素分析以确定与生存不良相关的临床病理变量。进一步分析了作为术前血小板计数函数的生存率，并对已知的预后因素进行了校正。
术前血小板计数大于300,000/μL的女性患者（n = 85）的5年累积生存率为65%，而血小板计数等于或小于300,000/μL的女性患者（n = 134）的5年累积生存率为84%（P = .004）。单因素Cox回归分析显示，非白人种族、病灶较大（大于4 cm）、血小板计数大于300,000/μL以及存在淋巴结转移是与预后不良相关的因素。血小板计数为300,000/μL或更低的患者与血小板计数大于300,000/μL的患者在种族、淋巴结转移和中位年龄方面无差异。然而，血小板计数大于300,000/μL的女性患者中病灶较大的比例更高（60例中有29例，而血小板计数为300,000/μL或更低的114例中有32例）。在多因素分析中，在调整年龄、种族、淋巴结转移的存在和病灶大小后，高血小板计数仍与预后不良相关（P = .04）。
血小板计数升高是早期宫颈癌患者生存不良的独立预后因素。
