结直肠癌患者合并癌性贫血的临床病理特征及预后分析

Clinicopathological features and prognosis of colorectal cancer patients with preoperative cancerrelated anemia

目的分析结直肠癌合并癌性贫血患者临床病理特征及预后。方法回顾性分析2003年1月到2009年7月间广州医学院第二附属医院收治的354例结直肠癌患者的临床资料。将术前血红蛋白低于120g／L者定为癌性贫血。结果354例结直肠癌患者中男195例．女159例，年龄22-92（中位年龄65）岁。女性患者（P〈0．01）、术前白蛋白下降者（P〈0.01）、右半结肠癌患者（P〈0.01）及全层浸润者（P〈0.05）更易出现癌性贫血。Cox多因素预后分析显示，癌性贫血是影响术后总体生存的独立危险因素（HR=1．60，95％CI：1．05-2．44；P〈0.05），但并不是影响术后无瘤生存的独立因素（HR=1．43．95％CI=0.97～2．12：P〉0.05）。结论合并癌性贫血在结直肠癌发展及预后中有重要作用．应引起临床关注。

Objective To analyze the clinicopathological features and prognosis of colorectal cancer patients with preoperative cancer-related anemia. Methods Clinical data of 354 patients with colorectal cancer in the Second Affiliated Hospital of Guangzhou Medical College from January 2003 to July 2009 were analyzed retrospectively. Those with hemoglobin （Hb）〈120 g/L before surgery were defined as cancer-related anemia. Results Of the 354 colorectal cancer cases, 195 were males and 159 were females. The median age was 65 （range 22-92） years. Preoperative cancer-related anemia tended to be occurred in female （P〈0.01） and those with preoperative albumin ≤35 g/L （P〈0.01）, right colon cancer （P〈0.01） and full-thickness invasion （P〈0.05）. Cox regression analysis showed preoperative cancer-related anemia was an independent unfavorable factor for overall survival （HR= 1.60, 95% CI： 1.05-2.44; P〈0.05）, but not for disease-free survival （HR=1.43, 95% CI：0.97-2.12; P〉0.05） in colorectal cancer. Conclusions Preoperative cancer-related anemia plays an important role in the development and prognosis of colorectal cancer and great attention should be paid to clinical practice.