Hematology And Clinical Characteristics Of The Patients With Malignant Tumors With Anemia As The First Manifestation

Objective:The diagnosis of Malignant tumors are likely concealed due to anemia is the first symptom of the patients and the optimal timing of treatment for malignant tumor may be losed.The research on the hematology and clinical characteristics of these patients can provide clinical evidence for early diagnosis and treatment for malignant tumors.Method:The seventy-two patients with anemia in the 967 Hospital of the Chinese People's Liberation Army(formerly the 210 th Hospital of the Chinese People's Liberation Army)from January 1,2017 to September 30,2019 were taken as the research objects using retrospective research method,The patients were divided into tumor group and non-malignant tumor group according diagnosis results,and indicators such as the RBC,Hb,HCT,MPV,MCH,MCHC,RDW,WBC,NEU,ANC,PLT,RDW,MPV,PCT,BUN between the two groups,SCr,ALT,AST,TP,ALB,GLB,LDH,TBIL,DBIL,IBIL,D-dimer,AFP,CEA,CA125,CA153,CA199,CA50,CA724,CA242,SF were studied and analyzed.Result:1.Among the 72 patients with anemia as the first symptom,21 patients were diagnosed as malignant tumors by comprehensive examination,accounting for 29.2% of all cases,and 51 patients with non-malignant tumors,accounting for 70.8%.Among 21 patients in the malignant tumor group,gastrointestinal tumors were the most common,16 cases,accounting for 76.19% of all malignant tumors;51 patients in the non-tumorgroup were confirmed to have hematological diseases,of which 15.69% the patients were malignant hematological diseases,and the rest were anemia due to essential deficiency for the formation of blood cells.2.Hb,WBC,NEU,ANC,PDW,D-dimer,CEA,CA125,CA199,CA724 from the patients in the tumor group were higher than that in the non-tumor group;RDW,ALT,TP,ALB,and LDH in the tumor group were lower than that in the non-tumor group.The difference between the two groups was statistically significant(P <0.05).3.The age of the patients in the tumor group,RBC,HCT,SCr,TBIL,DBIL,AFP,CA153,CA50,CA242 are higher than that in the non-tumor group;MCV,MCH,MCHC,PLT,MPV,PCT,SF,BUN,AST,GLB,IBIL were lower than that in the non-tumor group,but the difference between the two groups was not statistically significant(P> 0.05).4.WBC,NEU,ANC,Hb,RDW,PDW,TP,ALB,ALT,LDH,D-dimer,CEA,CA125,CA199,CA724 were included in multi-factor binary logistic regression analysis,Hb,ALB,LDH,D-dimer,CEA are independent risk factors for malignant tumors with anemia.5.The positive rates of 9 tumor markers in malignant tumor group and non-tumor group were 4.76%-42.86%,1.96%-15.69% respectively;the highest positive tumor markers were CEA and CA125,respectively.6.In the tumor group,6 case were mild anemia28.58%),14 cases moderate anemia(66.66%),severe anemia 1 case(4.76%),without extremely severe anemia.7.Among 21 tumor patients,carcinoembryonic antigen was raised from 9 cases(42.86%),carbohydrate antigen 125 was raised from 8 cases(38.11%),carbohydrate antigen 50 was raised from 7 cases(33.33%),carbohydrate antigen 72 was raised from 7cases(33.33%),carbohydrate antigen 199 increased in 6 cases(28.57%),carbohydrate antigen 242 increased in 6 cases(28.57%),carbohydrate antigen 153 increased in 1 case(4.76%),and alpha-fetoprotein increased in 1 case(4.76%).8.Among the tumor patients,all tumor markers were't be increased in 8 patients(38.10%)1 tumor marker increased in 3 cases(14.29%),2 tumor marker increased in 1case(4.76%),and 3 Tumor markers increased in 1 case(4.76%),4 tumor markers increased in 4 cases(19.05%),5 tumor markers increased in 3 cases(14.29%),and 6tumor markers increased in 1 case(4.76%).Conclusion:1.The incidence of malignant tumors is higher in patients with anemia as the first symptom.2.Slightly reduced hemoglobin,low albumin,decreased lactate dehydrogenase,increased D-dimer,and increased carcinoembryonic antigen are independent risk factors for anemia and malignant tumors.3.The hematological characteristics of the patients with malignant tumors with anemia as the first symptom were that Hb,WBC,NEU,ANC,and PDW form the patients in the tumor group were higher than than in the non-tumor group,and RDW was lower than that in the non-tumor group.Clinical characteristics of the patients were that anemia fronm mild to moderate and digestion Tumors are more common,D-dimer and tumor markers are higher than that in non-tumor group,and alanine aminotransferase,total protein,albumin,and lactate dehydrogenase are lower than that in the non-tumor group.4.For the patients with anemia as the first symptom,comprehensive and systematic examinations have important clinical significance in reducing the rate of missed diagnosis of malignant tumors in addition to hematological examinations,.