Clinical Importance of Mean Corpuscular Volume as a Prognostic Marker After Esophagectomy for Esophageal Cancer A Retrospective Study
Clinical Importance of Mean Corpuscular Volume as a Prognostic Marker After Esophagectomy for Esophageal Cancer A Retrospective Study
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DOI：
10.1097/sla.0000000000002971
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发表时间：
2020-03-01
影响因子：
9
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Yoshida, Naoya;Kosumi, Keisuke;Baba, Hideo
目的：阐明平均红细胞体积（MCV）对食管癌根治术患者预后预测的临床价值。背景：高MCV被认为与多种恶性肿瘤的发生和预后有关。然而，很少有研究调查MCV和食管癌的生存结局之间的相关性。方法：本研究纳入了2005年4月至2017年12月期间接受根治性食管切除术的570例食管癌患者。根据治疗前MCV的标准值将患者分为2组：正常组（83-99 fL）和高组（>99 fL）。回顾性比较两组患者的临床背景、短期预后和食管切除术后的预后。结果：MCV正常者410例（71.9%），MCV增高者160例（28.1%）。高MCV与较低的身体质量指数、较高的习惯性酒精和烟草使用频率以及食管癌以外的多种原发性恶性肿瘤的发生率显著相关。高MCV还与Clavien-Dindo分级>= II的术后发病率和肺部发病率较高相关。MCV高的患者总体生存率明显更差。多因素分析提示MCV高是生存不良的独立危险因素（危险比1.54，95%可信区间1.098-2.151，P = 0.012）。结论：MCV高的患者在临床背景中存在各种缺点，可能对食管切除术后的短期和长期结局产生不利影响。MCV可作为食管癌术后生存的预测指标。
Objective: To elucidate the clinical value of mean corpuscular volume (MCV) for prognostic prediction in patients with esophageal cancer who underwent radical esophagectomy. Background: High MCV is suggested to be relevant to the incidence and prognosis of several malignancies. However, few studies investigating the correlation between MCV and survival outcome of esophageal cancer have been conducted. Methods: This study included 570 patients with esophageal cancer who underwent radical esophagectomy between April, 2005 and December, 2017. Patients were divided into 2 groups according to the standard value of pretreatment MCV: normal (83-99 fL) and high (>99 fL) groups. Clinical backgrounds, short-term outcomes, and prognostic outcomes postesophagectomy were retrospectively compared between the groups. Results: Of all patients, 410 (71.9%) had normal MCV, and 160 (28.1%) had high MCV. High MCV was significantly associated with lower body mass index, higher frequency of habitual alcohol and tobacco use, and higher incidence of multiple primary malignancies other than esophageal cancer. High MCV also correlated with higher incidence of postoperative morbidity of the Clavien-Dindo classification >= II and pulmonary morbidity. Overall survival was significantly worse in patients with high MCV. Multivariate analysis suggested that high MCV was an independent risk factor for worse survival outcome (hazard ratio 1.54, 95% confidence interval 1.098-2.151, P = 0.012). Conclusions: Patients with high MCV have various disadvantages in clinical background that can adversely affect both short-term and long-term outcomes after esophagectomy. MCV can become a predictive marker to estimate survival outcome after esophagectomy for esophageal cancer.