Clinical significance of platelet count in patients with renal cell carcinoma
Clinical significance of platelet count in patients with renal cell carcinoma
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DOI：
10.1159/000106322
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发表时间：
2007-01-01
影响因子：
1.6
通讯作者：
Erten, Koray
中科院分区：
文献类型：
--
作者：
Erdemir, Fikret;Kilciler, Mete;Erten, Koray
前言：在过去的几十年中，许多预后因素已被研究用于预测肾细胞癌（RCC）的生存。血小板计数以前曾被报道与肾细胞癌的预后相关。本研究的目的是评估血小板增多在决定接受根治性肾切除术的局限性肾细胞癌患者预后中的意义。患者和方法：该研究包括118例连续患者。根据术前血小板计数将患者分为正常血小板计数组（组1）和血小板增多组（组2）。血小板增多症定义为血小板计数大于400，000/μ l。比较两组患者的分期分布、分级、肿瘤大小、组织学类型、血红蛋白水平、体重指数（BMI）、年龄、ECOG评分、性别、生存率等资料。采用Kaplan-Meier法比较生存率估计值，并采用考克斯模型进行多变量分析。结果：患者的平均年龄为61.4岁（范围30 - 78），平均随访时间为52.7 ± 19.6个月（范围9 - 96）。血小板增多23例（19.49%）。23例血小板增多症患者中有14例（60.86%）死于疾病进展。血小板增多症患者的预后比无血小板增多症患者差（p = 0.001）。74例pT 1-pT 2期疾病患者中有8例（10.81%）出现血小板增多，44例pT 3-pT 4期疾病患者中有15例（34.09%）出现血小板增多（p = 0.004）。在单因素分析中，血小板计数与T分期、血红蛋白水平、淋巴结阳性、ECOG评分和肿瘤大小相关。使用考克斯回归检验控制病理分期、肿瘤大小、血小板计数和淋巴阳性的既定预后指标，组间存活率的差异仍然显著（p < 0.05）。结论：血小板计数可作为肾癌根治术后患者的一个有用的预后指标。
Introduction: During the last decades numerous prognostic factors have been studied for predicting survival of renal cell carcinoma ( RCC). Platelet count has previously been reported to correlate with prognosis in RCC. The aim of the this study was to evaluate the significance of thrombocytosis in determining prognosis in patients with localized RCC who underwent radical nephrectomy. Patients and Methods: The study included 118 consecutive patients. Patients were divided into a normal platelet count group ( group 1) and a thrombocytosis group ( group 2) according to the preoperative platelet count. Thrombocytosis was defined as a platelet count greater than 400,000/mu l. The data about stage distribution, grade, tumor size, histological subtype, hemoglobin level, Body Mass Index ( BMI), age, ECOG score, gender, and survival rate of tumors between these two groups were compared. Survival estimates were compared with the Kaplan-Meier method and multivariate analysis was performed using a Cox model. Results: The mean age of the patients was 61.4 years ( range 30 - 78), and the mean follow- up period was 52.7 +/- 19.6 months ( range 9 - 96). Thrombocytosis was present in 23 patients ( 19.49%). Fourteen ( 60.86%) of 23 patients with thrombocytosis died of disease progression. Patients with thrombocytosis had a worse prognosis than patients without thrombocytosis ( p = 0.001). Thrombocytosis was noted in 8 ( 10.81%) of 74 patients with stage pT1- pT2 disease and in 15 ( 34.09%) of 44 patients with stage pT3- pT4 disease ( p = 0.004). In univariate analysis, platelet count was correlated with T stage, hemoglobin level, lymph node positivity, ECOG score, and tumor size. Controlling for established prognostic indicators of pathologic stage, tumor size, platelet count, and lymph positivity using Cox's regression test, the difference in survival between the groups remained significant ( p < 0.05). Conclusion: The platelet count can be considered a useful prognostic factor in patients with RCC who undergo radical nephrectomy.