Monreal M, Fernandez-Llamazares J, Piñol M, Julian J F, Broggi M, Escola D, Abad A
Department of Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Thromb Haemost. 1998 May;79(5):916-8.
In a previous report we found an inverse correlation between pre-operative platelet count (PlC) levels and the risk of post-operative pulmonary embolism in patients undergoing hip surgery. In the present study, we prospectively evaluated the prognostic significance of pre-operative PlC levels on survival in 180 consecutive patients undergoing surgery for colorectal cancer. Other major clinicopathological parameters studied were age, gender, Dukes' stage, duration of surgery, pre-operative haemoglobin levels and transfusion requirements. There were no significant differences in mean pre-operative PlC levels according to tumor stage. Thirty-three patients (18%) died during follow-up (3-23 months, median: 13 months). Univariate analysis (Kaplan-Meier estimates) showed that advanced tumor stage (p < 0.001), duration of surgery (p < 0.05) and a high pre-operative PlC level (p < 0.001) were significantly associated to a poor survival. The multivariate Cox analysis revealed that tumor stage (RR:5.734; 95%C.I.: 2.644-12.44), a high pre-operative PlC level (RR: 2.467; 95%C.I.: 1.117-5.452), and to a lesser extent the patients' age remained independent prognostic variables for mortality. The findings of this preliminary study may be of interest from the point of view of pathogenesis, but also clinically, since they might be used in the decision as to which patients or groups of patients should receive more aggressive therapeutic intervention.
在之前的一份报告中，我们发现接受髋关节手术的患者术前血小板计数（PlC）水平与术后肺栓塞风险呈负相关。在本研究中，我们前瞻性评估了180例连续接受结直肠癌手术患者术前PlC水平对生存的预后意义。研究的其他主要临床病理参数包括年龄、性别、杜克分期、手术时长、术前血红蛋白水平和输血需求。根据肿瘤分期，术前平均PlC水平无显著差异。33例患者（18%）在随访期间（3 - 23个月，中位值：13个月）死亡。单因素分析（Kaplan - Meier估计）显示，肿瘤分期进展（p < 0.001）、手术时长（p < 0.05）和术前PlC水平较高（p < 0.001）与较差的生存率显著相关。多因素Cox分析显示，肿瘤分期（RR：5.734；95%置信区间：2.644 - 12.44）、术前PlC水平较高（RR：2.467；95%置信区间：1.117 - 5.452），以及在较小程度上患者年龄仍然是死亡率的独立预后变量。这项初步研究的结果从发病机制角度以及临床角度可能都很有意义，因为它们可能用于决定哪些患者或患者群体应接受更积极的治疗干预。
