The significance of preoperative leukocytosis in endometrial carcinoma.
The significance of preoperative leukocytosis in endometrial carcinoma.
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DOI：
10.1016/j.ygyno.2012.03.043
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发表时间：
2012-06
影响因子：
4.7
通讯作者：
M. Worley;C. Nitschmann;M. Shoni;A. Vitonis;J. Rauh-Hain;C. Feltmate
中科院分区：
文献类型：
--
作者：
M. Worley;C. Nitschmann;M. Shoni;A. Vitonis;J. Rauh-Hain;C. Feltmate
目的探讨术前白细胞增多对子宫内膜癌患者的影响。方法回顾性分析2005年1月至2010年12月间所有子宫内膜癌手术治疗患者的临床资料。根据术前是否有白细胞增多（WBC≥10,000细胞/ μl）将患者分为两组。然后比较各组的病理结果、无进展生存期和总生存期。结果共检出1144例患者，术前有白细胞增生156例（13.6%），无白细胞增生988例（86.4%）。白细胞增多组出现3期（15.4% vs. 9.8%，粗值p=0.02）和4期（7.1% vs. 3.0%，粗值p=0.007）疾病的患者比例更高。白细胞增多与较大的平均肿瘤大小（4.4 vs. 3.4cm, p=0.0002）、较大比例的患者累及宫颈间质（14.8% vs. 8.7%，粗值p=0.02）、附件累及（14.1% vs. 7.5%，粗值p=0.007）和淋巴管间隙侵犯（24% vs. 16.3%，粗值p=0.02）相关。在多变量分析中，平均肿瘤大小（OR, 95% CI; 1.10, 1.02-1.18）仍然与术前白细胞增多显著相关。在复发时间方面，两组间无差异。然而，白细胞增多与死亡风险增加独立相关（HR, 95% CI; 1.69, 1.07-2.68）。结论子宫内膜癌患者术后白细胞增多与肿瘤大小增加独立相关，并独立增加死亡风险。
OBJECTIVETo evaluate the impact of preoperative leukocytosis among patients with endometrial carcinoma.METHODSThe medical records of all patients that underwent surgical treatment for endometrial carcinoma between January 2005 and December 2010 were retrospectively reviewed. Patients were separated into two groups based on the presence or absence of preoperative leukocytosis (WBC ≥10,000 cells per μl). The groups were then compared with respect to pathologic findings, progression-free survival and overall survival.RESULTS1144 patients were identified, 156 (13.6%) with preoperative leukocytosis and 988 (86.4%) without leukocytosis. The leukocytosis group had a greater percentage of patients with stage 3 (15.4% vs. 9.8%, crude p=0.02) and 4 (7.1% vs. 3.0%, crude p=0.007) disease. Leukocytosis was associated with a greater mean tumor size (4.4 vs. 3.4cm, p=0.0002) and a greater percentage of patients with cervical stromal involvement (14.8% vs. 8.7%, crude p=0.02), adnexal involvement (14.1% vs. 7.5%, crude p=0.007) and lymphvascular space invasion (24% vs. 16.3%, crude p=0.02). On multivariate analysis, mean tumor size (OR, 95% CI; 1.10, 1.02–1.18) remained significantly associated with preoperative leukocytosis. There was no difference between groups, with respect to time to recurrence. However, leukocytosis was independently associated with an increased risk of death (HR, 95% CI; 1.69, 1.07–2.68).CONCLUSIONSPreoperative leukocytosis, among endometrial cancer patients, was independently associated with increasing tumor size and independently imposed an increased risk of death.