Use of Preoperative Complete Blood Count/Differential Count Values to Predict Prognosis in Patients with Colorectal Cancer

利用簡單的術前血液常規檢查預估大腸直腸癌預後

游彥麟(Yen-Lin Yu) ； 范仲維(Jung-Wei Fan) ； 曾文科(Wen-Ko Tseng)

《中華民國大腸直腸外科醫學會雜誌》 24卷4期 (2013/12) Pp. 112-121

https://doi.org/10.6312/SCRSTW.2013.24(4).10210

摘要

Purpose. Colorectal cancer has recently become the third leading cause of cancer-related death in Taiwan. The Department of Health, R.O.C. (Taiwan), recommends that all citizens aged between 50 and 69 years undergo the fecal occult blood test. Following the implementation of this policy, the number of asymptomatic colorectal cancer cases detected has increased. In the present study, we aimed to determine a simple and routine examination that could be used to evaluate the prognosis of patients with colorectal cancer.Materials and Methods. Data were collected by reviewing patient records. From September 2006 to November 2008, 371 patients were diagnosed with colorectal cancer at Keelung Chang Gung Memorial Hospital, Taiwan. Of the 371 patients, 258 underwent tumor resection, and preoperative complete blood count/differential count (CBC/DC) data were available for 161 of these patients. Following resection of their tumors, the epidemiology, pathological findings, and follow-up information for each of these 161 patients were analyzed.Results. Patients with colorectal cancer who indicated a preoperative increase in absolute neutrophil count (ANC ＞ 5,650/mm^3), decrease in absolute lymphocyte count (ALC ＜ 1,350/mm^3), and increase in platelet count (PLT ＞ 360,000/mm^3) exhibited an increased recurrence rate and worse survival rate, after undergoing standard curative operations. Comparing to the pathological characteristic, the patients with colorectal cancer who had above preoperative lab data finding, also had high percentage of a larger tumor size (＞ 5 cm) and perineural invasion. Multivariate logistic regression analysis revealed that ANC values ＞ 5,650/mm^3 (p = 0.005) and ALC values ＜ 1,350/mm^3 (p = 0.041) are independent predictors of overall survival.Conclusion. CBC/DC is a routine test used in preoperative evaluation that can be used to easily obtain ANC, ALC, and PLT values. In the present study, we have indicated the potential of these values to predict the prognosis in patients with colorectal cancer. The ease and cost-effectiveness associated with this test, compared to other methods, further enhance its potential for the evaluation of the prognosis in patients with colorectal cancer.

關鍵字

大腸直腸癌 ； 白血球 ； 血小板 ； 預後

並列摘要

Purpose. Colorectal cancer has recently become the third leading cause of cancer-related death in Taiwan. The Department of Health, R.O.C. (Taiwan), recommends that all citizens aged between 50 and 69 years undergo the fecal occult blood test. Following the implementation of this policy, the number of asymptomatic colorectal cancer cases detected has increased. In the present study, we aimed to determine a simple and routine examination that could be used to evaluate the prognosis of patients with colorectal cancer.Materials and Methods. Data were collected by reviewing patient records. From September 2006 to November 2008, 371 patients were diagnosed with colorectal cancer at Keelung Chang Gung Memorial Hospital, Taiwan. Of the 371 patients, 258 underwent tumor resection, and preoperative complete blood count/differential count (CBC/DC) data were available for 161 of these patients. Following resection of their tumors, the epidemiology, pathological findings, and follow-up information for each of these 161 patients were analyzed.Results. Patients with colorectal cancer who indicated a preoperative increase in absolute neutrophil count (ANC ＞ 5,650/mm^3), decrease in absolute lymphocyte count (ALC ＜ 1,350/mm^3), and increase in platelet count (PLT ＞ 360,000/mm^3) exhibited an increased recurrence rate and worse survival rate, after undergoing standard curative operations. Comparing to the pathological characteristic, the patients with colorectal cancer who had above preoperative lab data finding, also had high percentage of a larger tumor size (＞ 5 cm) and perineural invasion. Multivariate logistic regression analysis revealed that ANC values ＞ 5,650/mm^3 (p = 0.005) and ALC values ＜ 1,350/mm^3 (p = 0.041) are independent predictors of overall survival.Conclusion. CBC/DC is a routine test used in preoperative evaluation that can be used to easily obtain ANC, ALC, and PLT values. In the present study, we have indicated the potential of these values to predict the prognosis in patients with colorectal cancer. The ease and cost-effectiveness associated with this test, compared to other methods, further enhance its potential for the evaluation of the prognosis in patients with colorectal cancer.

並列關鍵字

Colorectal cancer ； Absolute neutrophil count (ANC) ； Absolute lymphocyte count (ALC) ； Platelet count (PLT)