演題

胃癌における血小板数と血清Fibrinogenの臨床的意義:腫瘍進行度や予後の予測に有用な凝固系スコア―の検討

[演者] 有上 貴明:1,2
[著者] 上之園 芳一:2, 大久保 啓史:1, 貴島 孝:1, 天辰 仁彦:1, 川越 浩輔:1, 石神 純也:1, 柳田 茂寛:1, 夏越 祥次:1,2
1:鹿児島大学大学院 消化器・乳腺甲状腺外科学, 2:鹿児島大学大学院 分子応用外科学

Background: Some patients with early gastric cancer die of recurrent disease and cancer-related complications. Difficulties are associated with clinically predicting tumor progression and prognosis based on conventional tumor markers determined from preoperative blood examinations.
Objective: To investigate platelet count, plasma fibrinogen concentrations, and prothrombin activity in blood specimens from patients with gastric cancer and assess the clinical impact of combining platelet count with fibrinogen (CBS: coagulation blood score) as a prognostic marker.
Methods: We classified 275 patients with gastric cancer based on cut-off values for elevated platelet count ³295,000/mm3 and hyperfibrinogenemia ³305 mg/dL as CBS of 2 (both hematological abnormalities), 1 (one of these abnormalities) or 0 (neither abnormality).
Results: Platelet count, fibrinogen, and prothrombin activity correlated with the depth of tumor invasion, the presence or absence of lymph node metastasis, and stage (all P<0.05). The univariate analysis demonstrated platelet count and fibrinogen as prognostic factors (all P<0.05). According to the criteria of CBS, 101 (36.9%), 134 (48.9%), and 39 (14.2%) patients had CBS of 0, 1, and 2, respectively. CBS significantly correlated with the depth of tumor invasion, lymph node metastasis, and stage (all P<0.05). Prognostic differences among the groups were significant (P<0.01).
Conclusions: CBS is a potentially useful blood marker for predicting tumor progression and prognosis in patients with gastric cancer.
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