PDF(Pubmed)
Abstract：
UNASSIGNED: Anemia has long been associated with poor prognosis in patients with cervical cancer. Recently, additional hematologic parameters have emerged as potential indicators of worse outcome in this patient group. In a cohort of cervical cancer patients treated with chemoradiotherapy (CRT) and brachytherapy, we report on the prognostic significance of hematologic parameters including anemia, leukocytosis, neutrophil to lymphocyte ratio (NLR), and thrombocytosis, the effect of combining anemia with other hematologic parameters, and the effect of changes in hemoglobin levels during treatment.
UNASSIGNED: Two-hundred fifty-seven cervical cancer patients were retrospectively identified from a single cancer institution\'s database. Hematologic parameters were categorized as: anemia (hemoglobin ≤115 g/L), leukocytosis (white blood cell count >10 × 109/L), thrombocytosis (platelets >400 × 109/L), and NLR (ratio >5). The association between clinical factors and hematologic parameters on progression-free survival (PFS) and overall survival (OS) were assessed at 5 years.
UNASSIGNED: At 5 years, both pre-treatment anemia (PFS: 60% vs 34%, p < 0.0001; OS: 68% vs 41%, p < 0.0001) and on-treatment anemia (PFS: 62% vs 40%, p < 0.0001; OS: 70% vs 48%, p < 0.0001) were significantly associated with worse survival. This adverse effect on 5-year PFS and OS was increased in patients with both pre-treatment anemia and leukocytosis (PFS: 72% vs 42%, p < 0.0001; OS: 68% vs 37%, p < 0.0001) and pre-treatment anemia and elevated NLR (PFS: 61% vs 30%, p < 0.0001; OS: 68% vs 37%, p < 0.0001). Five-year PFS (50% vs 31%) and OS (60% vs 36%) was better in patients whose pre-treatment anemia improved to normal hemoglobin levels on treatment vs those patients who were anemic both pre- and on-treatment.
UNASSIGNED: Pre-treatment and on-treatment anemia were significant, independent predictors of worse PFS and OS. Anemia and other hematologic parameters remain prognostic markers for cervical cancer patients. Improvement in PFS and OS was seen in patients with normalization of hemoglobin.
UNASSIGNED: Two-hundred fifty-seven cervical cancer patients were retrospectively identified from a single cancer institution\'s database. Hematologic parameters were categorized as: anemia (hemoglobin ≤115 g/L), leukocytosis (white blood cell count >10 × 109/L), thrombocytosis (platelets >400 × 109/L), and NLR (ratio >5). The association between clinical factors and hematologic parameters on progression-free survival (PFS) and overall survival (OS) were assessed at 5 years.
UNASSIGNED: At 5 years, both pre-treatment anemia (PFS: 60% vs 34%, p < 0.0001; OS: 68% vs 41%, p < 0.0001) and on-treatment anemia (PFS: 62% vs 40%, p < 0.0001; OS: 70% vs 48%, p < 0.0001) were significantly associated with worse survival. This adverse effect on 5-year PFS and OS was increased in patients with both pre-treatment anemia and leukocytosis (PFS: 72% vs 42%, p < 0.0001; OS: 68% vs 37%, p < 0.0001) and pre-treatment anemia and elevated NLR (PFS: 61% vs 30%, p < 0.0001; OS: 68% vs 37%, p < 0.0001). Five-year PFS (50% vs 31%) and OS (60% vs 36%) was better in patients whose pre-treatment anemia improved to normal hemoglobin levels on treatment vs those patients who were anemic both pre- and on-treatment.
UNASSIGNED: Pre-treatment and on-treatment anemia were significant, independent predictors of worse PFS and OS. Anemia and other hematologic parameters remain prognostic markers for cervical cancer patients. Improvement in PFS and OS was seen in patients with normalization of hemoglobin.
摘要：
■长期以来，贫血与宫颈癌患者的不良预后相关。最近,在该患者组中,其他血液学参数已成为预后较差的潜在指标.在接受放化疗（CRT）和近距离放射治疗的宫颈癌患者队列中，我们报告了包括贫血在内的血液学参数的预后意义，白细胞增多,中性粒细胞与淋巴细胞比率（NLR），和血小板增多症,贫血与其他血液学参数相结合的效果，以及治疗期间血红蛋白水平变化的影响。
■从一个癌症机构的数据库中回顾性地确定了二百五十七名宫颈癌患者。血液学参数分类为：贫血（血红蛋白≤115g/L），白细胞增多（白细胞计数>10×109/L），血小板增多症(血小板>400×109/L),和NLR(比率>5)。在5年时评估临床因素和血液学参数与无进展生存期（PFS）和总生存期（OS）之间的关系。
■在5岁时，两种治疗前贫血（PFS：60%vs34%，p<0.0001;OS:68%vs41%,p<0.0001）和治疗中贫血（PFS：62%vs40%，p<0.0001;OS:70%vs48%,p<0.0001）与较差的生存率显着相关。在治疗前贫血和白细胞增多的患者中，这种对5年PFS和OS的不利影响增加（PFS：72％vs42％，p<0.0001;OS:68%vs37%,p<0.0001）和治疗前贫血和NLR升高（PFS：61%vs30%，p<0.0001;OS:68%vs37%,p<0.0001)。治疗前贫血改善至正常血红蛋白水平的患者与治疗前和治疗中贫血的患者相比，五年PFS（50％vs31％）和OS（60％vs36％）更好。
■治疗前和治疗中贫血显著，PFS和OS较差的独立预测因子。贫血和其他血液学参数仍然是宫颈癌患者的预后指标。血红蛋白正常化患者的PFS和OS改善。
■从一个癌症机构的数据库中回顾性地确定了二百五十七名宫颈癌患者。血液学参数分类为：贫血（血红蛋白≤115g/L），白细胞增多（白细胞计数>10×109/L），血小板增多症(血小板>400×109/L),和NLR(比率>5)。在5年时评估临床因素和血液学参数与无进展生存期（PFS）和总生存期（OS）之间的关系。
■在5岁时，两种治疗前贫血（PFS：60%vs34%，p<0.0001;OS:68%vs41%,p<0.0001）和治疗中贫血（PFS：62%vs40%，p<0.0001;OS:70%vs48%,p<0.0001）与较差的生存率显着相关。在治疗前贫血和白细胞增多的患者中，这种对5年PFS和OS的不利影响增加（PFS：72％vs42％，p<0.0001;OS:68%vs37%,p<0.0001）和治疗前贫血和NLR升高（PFS：61%vs30%，p<0.0001;OS:68%vs37%,p<0.0001)。治疗前贫血改善至正常血红蛋白水平的患者与治疗前和治疗中贫血的患者相比，五年PFS（50％vs31％）和OS（60％vs36％）更好。
■治疗前和治疗中贫血显著，PFS和OS较差的独立预测因子。贫血和其他血液学参数仍然是宫颈癌患者的预后指标。血红蛋白正常化患者的PFS和OS改善。
