消化道恶性肿瘤患者外周血象的变化及意义

目的探讨消化道恶性肿瘤患者外周血象的变化及意义。方法将我院2003年1月—2006年12月内科收治的173例消化道恶性肿瘤患者治疗前的血常规指标,与同期来我院进行健康体检的企事业单位健康人群9 766例进行比较。结果消化道恶性肿瘤患者的红细胞计数、血红蛋白、红细胞压积均减少,平均红细胞体积、平均红细胞血红蛋白量增高,均表现为巨幼细胞性贫血,骨髓象呈增生性贫血改变,而白细胞总数的变化较小,白细胞分类,中性粒细胞百分比超过正常范围与淋巴细胞百分比低于正常范围者多见,血小板数异常远较血红蛋白与白细胞为少,但36例肝癌患者中28例出现血小板减少。结论临床上应重视消化道肿瘤高危因素人群外周血象的变化,尤其是良恶性贫血的鉴别,以免漏诊、误诊。

Changes in Peripheral Hemogram of Patients with Malignant Digestive Tumor and Its Significance

Objective To discuss the changes in peripheral hemogram of the patients with malignant digestive tumor and their significance. Methods The blood routine test parameters of 173 patients with malignant digestive tumor between Jan. 2003 and Dec. 2006 were compared with that of 9,766 subjects from local enterprises who experienced physical examination. Results Erythrocyte count, hemoglobin concentration and hematocrit of all the patients with malignant digestive tumor decreased, mean corpuscular volume and mean corpuscular hemoglobin increased, and there was uneonspieuous change in total leukocyte count. The indications of megaloblastic anemia and proliferative anemia in bone marrow hemogram were found in the patients. It was common that the percentage of neutrophils was higher and that of lymphocytes was lower than that of the normal controls. Condusion The changes in peripheral hemogram of the highly risky group with malignant digestive tumor, which need to be differentiated from that of benign or malignant anemia, should be paid more attention to, so that misdiagnosis can be avoided.