血小板增多与肺癌患者临床病理特征及其预后的相关性分析

Analysis on correcation of thrombocytosis with clinicopathologic characteristics in prognosis of patients with lung cancer

目的探讨血小板增多与肺癌患者临床病理特征及其预后的关系。方法比较119例血小板增多肺癌患者与123例血小板正常肺癌患者血小板指标的变化,分析两组患者临床病理特征以及预后的差异。结果两组患者的血小板压积(t=14.03,P<0.001)、血小板平均体积(t=10.29,P<0.001)和血小板分布宽度(t=7.58,P<0.001)之间差异有统计学意义,血小板增多与患者的TNM(tumor node metastasis)分期(Z=-5.14,P<0.001)、淋巴结转移(X2=4.25,P=0.039)、远处转移(X2=6.08,P=0.014)以及是否吸烟(X2=5.42,P=0.020)等临床病理特征相关;两组患者的生存期分布有差异(X2=4.51,P=0.034);Cox回归模型结果显示血小板增多的肺癌患者其死亡风险是对照组的1.002倍(RR=1.002,P=0.005)。结论血小板计数的增多通常伴随着血小板形态的异常,且血小板增多与肺癌患者的TNM分期、淋巴结转移、远处转移及吸烟等因素相关,血小板计数是肺癌患者独立的不良预后指标。

Objective To explore the relationship between thrombocytosis and clinicopathologic characteristics in prognosis of patients with lung cancer. Methods The changes of platelet parameters in lung cancer patients between 119 cases of the thrombocytosis and 123 cases of the normal platelet count were compared. The differences of elinicopathologic characteristics and prognosis between two groups were analyzed. Results Significant differences was observed in platelet parameter distribution of two groups （ P 〈 0. 001 ）. Thrombocytosis was found to have correlation with some clinicopathologic characteristics in lung cancer patients such as tumor node metastasis （TNM） stages （ Z = - 5. 14, P 〈 0. 001 ） ,lymph node invasion （x2 = 4. 25, P = 0. 039）, distant metastasis （x2 = 6. 08, P = 0. 014） and smoking （x2 =5.42, P =0. 020）. The overall survival was found to have the difference （ x2 =4. 51, P =0. 034） of the risk of death in the two groups. The result of Cox regression model showed that the mortality risk in lung cancer patients with thrombo- eytosis was 1. 002 times as compared with the control group（ RR = 1. 002, P = 0. 005 ）. Conclusions Increased platelet count is usu- ally accompanied by the platelet morphological abnormalities, and thrombocytosis is related to TNM stages, metastasis and smoking in lung cancer patients. Platelet count is an independent indicator of deteriorated prognosis for patients with lung cancer.