青海地区胃癌相关性贫血的临床研究

Clinical studies of gastric cancer-related anemia in qinghai China

目的:通过青海地区胃癌患者的贫血状况的分析,明确本地区贫血与胃癌分期及化疗效果的相关性。方法:收集2004年6月到2008年4月来院治疗的胃癌患者258例,检查血常规以了解贫血的状况,分析贫血发生率与肿瘤分期的关系。跟踪病例化疗情况,分析化疗后贫血发生率及其与预后间的关系。结果:样本中贫血发生率为43.8%。其中女性中为51.8%;男性中为41.6%,无显著性差异。在258例病人中具有完整TNM分期的195例,胃癌患者的贫血发生率根据肿瘤分化程度、肿瘤分期、浸润深度、淋巴结转移、远处转移、肿瘤大小、年龄不同有显著性差异。肿瘤在胃贲门区、胃体部、胃窦区贫血发生率无显著性差异。258例胃癌患者接受三周期化疗后,贫血病人为161例。其中化疗后出现贫血的病人有46例,疾病控制率(DCR)为78.26%,客观缓解率(ORR)为21.74%。而化疗后无贫血的17例病人,疾病控制率(DCR)94.12%,客观缓解率(ORR)为52.94%。贫血组和非贫血组的DCR和ORR有显著性差异。在化疗过程中,15例病人接受了输血治疗,没有关于铁剂及促红细胞生成素(Erythropoietin,EPO)治疗的记录。结论:按NCI标准判断,青海地区胃癌相关性贫血的发生率与国内其他地区发生率相近。胃癌相关性贫血的发生率与肿瘤分化程度、肿瘤分期、浸润深度、淋巴结转移、远处转移、肿瘤大小、年龄有关。化疗过程中发生贫血的病人对化疗的反应差,化疗过程中未发生贫血的病人疗效较好。本研究中贫血的发生率与患者性别及肿瘤的部位无关。

Objective：To elucidate the correlation of anemia with tumor progession and the curative effect of chemotherapy in Qinghai.We studied anemia status of patients with gastric cancer.Methods：Total of 258 cases of gastric cancer were collected,the situation of anemia was evaluated through the first patients＇ routine blood inspection,anemia status after chemotherapy.Results：Among 258 cases,113 cases with anemia were identified,the incidence rate was 43.8%,there was no significant difference between male and female.Among 195 cases with complete TNM staging,analysis showed significant differences in anemia incidence according to different degree of tumor differentiation,tumor stage,depth of invasion,lymph node metastasis,distant metastasis,tumor size and age.Otherwise,it showed no significant differrence in tumor originated from different gastric site.After three cycles of chemotherapy,anemia cases rised to 161,46 patients arose anemia in the course of chemotherapy,17 patients did not appear anemia in full course of chemotherapy.There were significant differences in ORR and DCR between the two groups.In chemotherapy,fifteen patients accepted blood transfusion therapy,there was no record about iron and EPO therapy.Conclusion：Diagnosed by NCI standards,the incidence of gastric cancer-related anemia in Qinghai is similar to other parts of ChinaThe incidence of anemia correlated with tumor progression and age.Patients with anemia happened in chemotherapy had worse effect.The incidence of anemia was irrelevant to gender and tumor site.