| Objective:Cancer-related anemia is a common clinical complication that occurs in tumor patients during the development and treatment of the disease,which not only reduces the sensitivity and quality of life of patients to radiotherapy and chemotherapy,but also affects the prognosis of patients as an independent factor.Through retrospective investigation,this study clarified the incidence,diagnosis and treatment of tumor-related anemia,especially digestive system tumor anemia;and based on hemoglobin indicators at the first diagnosis and 6 months later,the dynamic changes of anemia in tumor patients were initially clarified.Method:The clinical data of patients with solid tumor hospitalized for the first time in the Department of Hematology and Oncology,Dongzhimen Hospital of Beijing University of traditional Chinese Medicine from January 1,2015 to September 30,2020 were collected by retrospective study.Basic information,clinical data and laboratory examination of patients were collected.(1)The effects of sex,age,KPS score,nutritional index(albumin,BMI,total cholesterol),immunological index,tumor type and stage,and anti-tumor therapy on the occurrence of anemia were observed.For patients with CRA,statistics were made on the laboratory examination and treatment methods of the patients,and the clinical treatment characteristics,specific methods and treatment norms of the patients were analyzed.(2)Through the collection of the patient's clinical medical records after 6 months,the dynamic changes of the patient's anemia were preliminarily discussed.(3)For patients with malignant tumors of the digestive system,analyze the relationship between age,sex,nutritional status,course of disease,tumor stage and anemia.Results:A total of 979 patients with malignant solid tumors were included in this study,and 146 patients were followed up for 6 months.A total of 411 patients with digestive system malignant tumors were screened out of 979 malignant solid tumors.1.Anemia in the first hospitalization(1)The incidence of anemia in 979 cases of malignant solid tumors was 41.98%,and the incidence of mild,moderate,severe,and extremely severe anemia was 21.6%,13.7%,4.4%,and 2.3%,respectively.The incidence of orthocytic,macrocytic,and small cell anemia was 81.2%,7.1%,and 11.7%.The incidence of anemia in 411 patients with malignant tumors of the digestive system was 51.6%.The incidence of mild,moderate,severe,and extremely severe anemia was 26.5%,16.1%,5.1%and 3.9%.The incidence of orthocytic,macrocytic,and small cell anemia was 75.5%,9.4%,and 15.1%.(2)?Type of tumor:Among the 979 malignant solid tumors.the incidence of anemia in patients with gastric cancer was the highest,reaching 65.5%,followed by patients with cervical cancer and esophageal cancer,with incidences of 57.1%and 51.8%,respectively.The incidence of anemia in breast cancer patients was the lowest at 22.2%.Among the 411 cases of malignant tumors of the digestive system,the top 3 tumors with anemia rate were gastric cancer,esophageal cancer,and liver cancer,which were 65.5%,51.8%,and 51.4%,respectively.?Tumor staging:The incidence of anemia in 979 cases of malignant solid tumors in stage ?,?,? and ? patients were 12.0%,25.4%,41.1%and 45.2%,respectively.The incidence of stage?+? anemia in 411 patients with malignant tumors of the digestive system was 30.2%,and the incidence of anemia in stage ?+? patients was 51.9%.?Course of disease:Among the 979 malignant solid tumors,the incidence of anemia in the group of ?6 months was 41.2%,and the incidence of anemia in the group of courses of less than 6 months was 43.2%.There was no significant difference between the two groups(P>0.05).The incidence of anemia in the 411 patients with malignant tumors of the digestive system was 53.8%in the course of disease?6 months,and the incidence of anemia in the group with course of disease<6 months was 49.8%.There was no significant difference between the two groups(P>0.05).?Previous anti-tumor treatment and anemia:The incidence of anemia in patients who had never received western medicine was 44.4%;the incidence of anemia in chemotherapy group was 69.0%:the incidence of anemia in endocrine group was 15.9%;the incidence of anemia in targeted group was 28.1%.In anti-tumor therapy,the incidence of anemia in endocrine and targeted therapy was lower,and the degree of anemia was mild,and the incidence of anemia in chemotherapy was the highest.(3)?Gender:The overall incidence of anemia in male patients was 49.30%,and the incidence of anemia in female patients was 34.31%.The incidence of anemia in male patients was higher than that in female patients,and the difference was statistically significant(P<0.05)The incidence of anemia in male patients with tumors of the digestive system was 56.1%,and the incidence of anemia in female patients was 44.2%.The incidence of anemia in male patients was higher than that in female patients,and the difference was statistically significant(P<0.05)?Age:The incidence of anemia was 37.5%in the overall age group?60 years old.and the incidence of anemia in the group age>60 years old was 44.3%.The incidence of anemia in the group age>60 years old was higher than that in the group age?60 years old,there was no statistical difference between the two groups(P>0.05),The incidence of anemia in the group of digestive system tumors ?60 years old was 46.0%,and the incidence of anemia in the group older than 60 years was 54.4%.The incidence of anemia in the group older than 60 years old was higher than that in the group younger than 60 years old.There was no statistical difference between the two groups(P>0.05).?Nutrition factors and anemia:The incidence of anemia in the overall BMI<18.5 kg/m2 group was 62.4%,the incidence of anemia in the BMI 18.5-23.9 kg/m2 group was 44.9%,and the incidence of anemia in the BMI>23.9 kg/m2 group was 31.4%.The smaller the BMI value,the higher the incidence of anemia in patients,and the difference was statistically significant(P<0.05).The incidence of anemia in the albumin reduction group was 63.8%,and the incidence of anemia in the normal albumin group was 25.9%,the difference was statistically significant(P<0.05).In patients with digestive system tumors,the incidence of anemia in the group with BMI<18.5 kg/m2 was 61.8%,the incidence of anemia in the group with BMI 18.5-23.9 kg/m2 was 54.1%,and the incidence of anemia in the group with BMI>23.9 kg/m2 was 39.0%.Smaller,the higher the incidence of anemia in patients,the difference was statistically significant(P<0.05).The incidence of anemia in the albumin reduction group was 67.6%,and the incidence of anemia in the normal albumin group was 37.2%,the difference was statistically significant(P<0.05).2.Diagnosis and treatment of anemia in the first hospitalizationAmong the 411 patients with CRA,39.7%had a clear diagnosis of anemia,and 142 patients were treated for anemia correction.The treatment rate for anemia was 34.5%,and the treatment rate for mild,moderate,severe,and extremely severe anemia was 15.6%,45.5%,65.1%,87.0%.The blood transfusion treatment rate was 38.0%(54/142).The iron treatment rate was 34.5%(49/142),and the treatment rate of folic acid and vitamin B12 was 4.2%(6/142).The EPO treatment rate was 9.2%(13/142),and the average Hb of patients before treatment was 77.67 g/L.The treatment rate of Chinese patent medicine was 54.9%(78/142).The medicine were compound donkey-hide gelatin and Yiqi Weixue granules.3.Anemia at 6 monthsAmong the 979 patients with malignant solid tumors,there were 146 patients with follow-up data after 6 months.The average Hb of the patients at the first visit was 121.7 g/L,and the incidence of anemia was 26.0%(38/146).After 6 months,the average Hb of patients was 122.8 g/L,and the incidence of anemia was 28.8%(42/104).There was no significant difference in Hb value and the incidence of anemia before and after enrollment(P>0.05).Conclusions:1.The incidence of anemia in 979 patients with malignant solid tumors was 41.98%.Different tumor types have different incidences of anemia.The top 3 tumors with anemia incidence were gastric cancer,cervical cancer,and esophageal cancer.Male,late tumor stage,poor nutrition and physical fitness were related factors that affected the incidence of anemia.The diagnosis rate of 411 patients with anemia was 39.7%,and the treatment rate was 34.5%.2.The incidence of anemia in 411 patients with malignant tumors of the digestive system was 51.6%,and the top 3 tumors in the order of incidence of anemia were gastric cancer,esophageal cancer,and liver cancer.Male,late tumor stage,decreased albumin level,and low BMI were related factors that affected the occurrence of anemia.3.The incidence of anemia in 146 patients with 6-month medical history data was 26.0%at the first visit,and the incidence of anemia in patients 6 months later was 28.8%. |
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