外周血单核细胞计数与结直肠癌肝转移的关系

Relationship between preoperative peripheral blood monocyte count and liver metastasis of colorectal cancer

目的探讨术前外周血单核细胞计数与结直肠癌肝转移的关系。方法收集2003年12月至2015年5月住院手术治疗的结直肠癌患者195例的临床资料,根据患者术前是否有肝转移灶分为肝转移组30例和无肝转移组16例。对患者临床病理特征进行单因素分析,对结直肠癌肝转移危险因素进行多因素Logistic回归分析,以确定单核细胞计数是否与结直肠癌肝转移有关联。结果 103例结肠癌中26例发生肝转移,92例直肠癌中4例发生肝转移。单因素分析显示,肝转移组和无肝转移组患者的性别、年龄、原发肿瘤最大直径、分化程度差异均无统计学意义(P均>0.05);两组患者在术前单核细胞计数、T分期、N分期、肿瘤原发部位差异有统计学意义(P均<0.01)。结直肠癌肝转移危险因素的Logistic回归分析显示,术前高单核细胞计数是结直肠癌患者发生肝转移的独立危险因素(OR:8.172,95%CI:3.685~18.119,P<0.01)。结论升高的术前外周血单核细胞计数与结直肠癌肝转移相关,可能通过导致肿瘤患者处于免疫抑制状态促进了结直肠癌肝转移。

Objective To analyze the relationship between preoperative peripheral blood monocyte count and liver metastasis of colorectal cancer. Methods Clinical data of 195 patients with colorectal cancer who underwent operation in Chinese PLA general hospital from December 2003 to May 2015 were retrospectively analyzed. The patients were divided into liver metastasis group( n = 30) and no-liver metastasis group( n = 165) according to whether the patients had hepatic metastatic focus. Univariate analysis and multivariate logistic regression analysis were carried out to investigate the association of preoperative peripheral blood monocyte count with liver metastasis. Results liver metastasis occurred in 26 out of 103 colon cancer patients and 4 out of 92 rectal cancer patients. Univariate analysis showed that there were no significant differences in patients' sex and age,maximum diameter and differentiation degree of primary tumor between two groups( all P >0. 05),while there were significant differences in preoperative peripheral blood monocyte count,T classification,N classification and primary site of tumor between two groups( all P < 0. 01). Multivariate Logistic regression analysis revealed that preoperative high monocyte count was the independent risk factor for liver metastasis of colorectal cancer patients( OR:8. 172,95% CI: 3. 685- 18. 119,P < 0. 01). Conclusions Preoperative high peripheral blood monocyte count is associated with liver metastasis of colorectal cancer patients,and elevated monocyte count can facilitate the liver metastasis in colorectal cancer patients probably through leading to patients' immune suppression status.