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頁籤選單縮合
題名 | Use of Preoperative Complete Blood Count/Differential Count Values to Predict Prognosis in Patients with Colorectal Cancer=利用簡單的術前血液常規檢查預估大腸直腸癌預後 |
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作者姓名(中文) | 游彥麟; 范仲維; 曾文科; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 24:4 2013.12[民102.12] |
頁次 | 頁112-121 |
分類號 | 416.245 |
關鍵詞 | 大腸直腸癌; 白血球; 血小板; 預後; Colorectal cancer; Absolute neutrophil count; ANC; Absolute lymphocyte count; ALC; Platelet count; PLT; |
語文 | 英文(English) |
中文摘要 | 近年來大腸直腸癌是國內癌症死亡率第三名的疾病。也由於此原因國民健康局開始對所有50到69歲的國民推行從糞便潛血試驗檢查。也因為此一政策,有越來越多新的、沒有症狀的大腸直腸癌患者被診斷出來。而我們希望可以藉由一些術前的常規檢驗,是否可以發現一些因子進而來預測大腸直腸癌術後的狀況。我們統計了從2006年9月到2008年11月共371位在基隆長庚紀念醫院被確診為大腸直腸癌患者的病歷資料,其中有258位病人接受了手術治療。而其中161位病人有完整的術前血液常規檢查報告。手術之後,我們統計了病人的基本資料、血液常規檢查、病理報告以及追蹤資料來進行研究。在我們的資料庫當中,若大腸直腸癌病患的術前血液常規檢查中:ANC > 5,650/mm^3、ALC < 1,350/mm^3以及PLT > 360,000/mm^3。病人術後將有較高的復發機率以及較低的五年存活比率。除此之外,對照了病理報告之後,有以上特徵的病人,其病理報告腫瘤直徑大於五公分的比例以及有周邊神經源侵犯的比例也較高。經過多變像分析之後,ANC > 5,650/mm^3、ALC < 1,350/mm^3兩項因子對於術後五年存活率而言皆是獨立的變相因子。其實血液常規檢驗對術前評估而言是一項基本的檢查,而我們可以很輕易的經由術前血液常規檢驗來得到ANC、ALC、以及PLT的數值。相對於其他較昂貴的檢驗,也許簡單的術前血液常規檢查,將可以有效的運用在對大腸直腸癌病人術後的預後評估。 |
英文摘要 | Purpose. Colorectal cancer has recently become the third leading cause of cancer-related death in Taiwan. The Department of Health, R.O.C. (Taiwan), recommends that all citizens aged between 50 and 69 years undergo the fecal occult blood test. Following the implementation of this policy, the number of asymptomatic colorectal cancer cases detected has increased. In the present study, we aimed to determine a simple and routine examination that could be used to evaluate the prognosis of patients with colorectal cancer.Materials and Methods. Data were collected by reviewing patient records. From September 2006 to November 2008, 371 patients were diagnosed with colorectal cancer at Keelung Chang Gung Memorial Hospital, Taiwan. Of the 371 patients, 258 underwent tumor resection, and preoperative complete blood count/differential count (CBC/DC) data were available for 161 of these patients. Following resection of their tumors, the epidemiology, pathological findings, and follow-up information for each of these 161 patients were analyzed.Results. Patients with colorectal cancer who indicated a preoperative increase in absolute neutrophil count (ANC > 5,650/mm^3), decrease in absolute lymphocyte count (ALC < 1,350/mm^3), and increase in platelet count (PLT > 360,000/mm^3) exhibited an increased recurrence rate and worse survival rate, after undergoing standard curative operations. Comparing to the pathological characteristic, the patients with colorectal cancer who had above preoperative lab data finding, also had high percentage of a larger tumor size (> 5 cm) and perineural invasion. Multivariate logistic regression analysis revealed that ANC values > 5,650/mm^3 (p = 0.005) and ALC values < 1,350/mm^3 (p = 0.041) are independent predictors of overall survival.Conclusion. CBC/DC is a routine test used in preoperative evaluation that can be used to easily obtain ANC, ALC, and PLT values. In the present study, we have indicated the potential of these values to predict the prognosis in patients with colorectal cancer. The ease and cost-effectiveness associated with this test, compared to other methods, further enhance its potential for the evaluation of the prognosis in patients with colorectal cancer. |
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