胃癌、结直肠癌患者以慢性贫血为首发表现的危险因素分析

Analysis of risk factors of chronic anemia as the first manifestation in patients with gastric canceror colorectal cancer

[目的]探讨无明显消化道症状以慢性贫血为首发表现的胃癌、结直肠癌患者危险因素。[方法]回顾性搜集2015-06-2018-06期间以慢性贫血为首发表现的胃癌、结直肠癌患者72例的临床资料,采用χ^2检验和Logistic回归分析癌患者与性别、年龄、计算机断层扫描(CT)、肿瘤标志物、病理特征的相关性。[结果]①72例中,胃癌39例(54.2%),结直肠癌33例(45.8%)。39例胃癌患者中男25例,女14例,平均年龄(67.6±11.5)岁;33例结直肠癌患者中男19例,女14例,平均年龄(62.4±13.0)岁。②χ^2检验结果显示,胃癌患者中以慢性贫血为首发症状者与非慢性贫血者的年龄、CT表现、肿瘤分期、大便潜血上比较差异有统计学意义(P<0.05~0.01);结直肠癌患者中以慢性贫血为首发症状者与非慢性贫血患者在肿瘤部位、肿瘤直径、大便潜血、血清CEA、血清CA199上比较差异有统计学意义(P<0.05~0.01)。③二分类Logistic回归分析结果显示,无明显消化道症状的胃癌患者中,年龄≥60岁、CT阳性、Ⅲ/IV期、大便潜血阳性的慢性贫血风险高;无明显消化道症状的结直肠癌患者中,右半结肠、肿瘤直径≥5 cm、大便潜血阳性、血清CEA阴性、血清CA199阴性的慢性贫血风险高。[结论]无明显消化道症状的胃癌患者年龄、CT表现、肿瘤分期、大便潜血是发生慢性贫血的危险因素,无明显消化道症状的结直肠癌患者肿瘤部位、肿瘤直径、大便潜血、肿瘤标志物是慢性贫血的危险因素,当患者合并高危因素时应考虑到消化道恶性肿瘤可能。

[Objective]To investigate the risk factors in gastric cancer or colorectal cancer patients with chronic anemia as the first manifestation.[Methods]The clinical data of admitted gastric cancer or colorectal cancer patients with the primary symptom of chronic anemia were retrospectively collected from June 2015 to June 2018 in the Renmin Hospital of Wuhan University.The relationships among the sex,age,computed tomography(CT),tumor markers,and pathological features of the patients were analyzed by χ2 test and logistic regression.[Results]①In the 72 cases patients present chronic anemia as the first manifestation,including 39 cases of gastric cancer(54.2%)and 33 cases of colorectal cancer(45.8%).The patients of gastric cancer with chronic anemia as the first manifestation were 25 males,14 females with average age(67.6±11.5)years;patients of colorectal cancer with chronic anemia as the first manifestation were 19 males and 14 females with average age(62.4±13.0)years.② χ2 test showed that there was a significant difference in age,CT,pathological staging and occult blood in patients with chronic anemia in gastric cancer without obvious digestive tract symptoms(P<0.05-0.01);there was a significant difference in tumor location,tumor size,fecal occult blood,serum CEA,and serum CA199 in patients with chronic anemia in colorectal cancer without obvious digestive tract symptoms(P<0.05-0.01).③Two-class logistic regression analysis showed that age≥60 years old,CT positive,stage III/IV,stool occult blood positive had risk with chronic anemia in gastric cancer patients without obvious digestive tract symptoms;right colon,tumor diameter≥5 cm,stool occult blood positive,serum CEA negative,serum CA199 negative had high risk with chronic anemia in colorectal cancer patients without obvious digestive tract symptoms.[Conclusion]Age,computed tomography manifestations,pathological staging and stool occult blood are risk factors for chronic anemia in gastric cancer patients without obvious digestive tract symptoms;tumor location,tumor diameter,stool occult blood and tumor markers are risk factors for chronic anemia in colorectal cancer patients without obvious digestive tract symptoms,the possibility of digestive tract malignant tumors should be considered when patients are complicated with high risk factors.