胃癌患者治疗前贫血相关因素临床分析.docVIP

胃癌患者治疗前贫血相关因素临床分析【摘要】 目的 研究胃癌患者治疗前贫血发生率及其相关因素。方法 回顾性分析我院近五年的住院胃癌患者资料,比较有贫血组在年龄、性别、胃基础疾病、TNM分期和病理组织类型与无贫血组的差异。 结果 342例胃癌患者确诊时有贫血者191例,占56.1%(191/342),其中NCIⅠ级83例(43.5%),Ⅱ级66例(34.6%),Ⅲ级24例(12.6%),Ⅳ级18例(9.4%)。贫血组与无贫血组在有无骨髓转移、TNM分期、癌细胞分化程度的差异具有统计学意义。结论 胃癌患者有较高的贫血发生率,有骨髓转移、较晚的TNM分期和癌细胞分化程度的差者易发生贫血。 【关键词】 胃癌;贫血 Clinical analysis of factors related to anemia in patients with stomach cancer before treatment SHOU Tao,WANGXiao-jie,ZENG Rong, et al.Center of Oncology,the First Peoples Hospital of Yunnan Province,Yunnan 650032,China 【Abstract】 Objective To study the incidence of anemia in patients with gastric cancer before treatment and its related factors.Methods Clinical data of 342 in-patients with stomach cancer were collected retrospectively,the differences of age,gender,accompanied gastric diseases,TNM stage,and histopathology type between patients with and without anemia were compared.Results The incidence of anemia was 56.1%(191/342) in patients with stomach cancer.The cases of anemia in NCI grade I,Ⅱ,Ⅲ and Ⅳ were 83 (43.5%),66(34.6%),24(12.6%) and 18(9.4%).There were significant differences of the bone marrow metastasis,late TNM stage,poor tumor differentiation between those with and without anemia.Conclusion The incidence of anemia inpatients with stomach cancer before treatment is high.Anemia tends to happen in those with bone marrow metastasis,late TNM stage and poor tumor differentiation. 【Key words】Gastric cancer; Anemia 胃癌是我国的常见恶性肿瘤,贫血是其常见并发症。多项研究表明贫血是与肿瘤患者生存相关的独立影响因素[1,2],纠正贫血有利于改善转归。然而,胃癌相关性贫血的原因尚不清楚,尤其是化疗或手术前就出现贫血的患者,针对这方面的研究较少。临床常常给于患者输血或促红细胞生成素处理,难以取得持续满意的疗效,因此,我们通过本院近5年的住院胃癌患者资料分析,探讨胃癌患者接受手术或化疗前发生贫血的多种因素。 1 资料与方法 1.1 一般资料 收集本院2005~2009年住院胃癌患者病历资料,要求有病理资料,无原发肝肾疾病、血液系统疾病、化疗史、输血史、明确的出血史及上消化道手术史。符合上述要求的病例共342例,其中男238例,平均年龄(53.4±8.6)岁,女性104例,平均年龄(54.2±9.6)岁。 1.2 数据收集 纪录患者接受手术、化疗、输血、促红细胞生成素、铁剂治疗前的临床和实验室资料,包括胃镜证实的胃部基础疾病(胃/十二指肠溃疡、慢性萎缩性胃炎、糜烂性胃炎、反流性食道炎、幽门梗阻)、胃癌病理类型、TNM临床分期、贫血NCI分级(National Cancer Institute,NCI)、骨髓转移情况等。 1.3 相关标准 胃癌TNM分期采