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White Blood Cell Count Range and Cancer Prognosis
Introduction to White Blood Cell Count in Cancer
White blood cell (WBC) count is a critical parameter in the diagnosis and prognosis of various cancers. Elevated or altered WBC counts can indicate the presence of inflammation, infection, or malignancy. This article synthesizes research findings on the range of WBC counts in cancer patients and their prognostic implications.
WBC Count as a Prognostic Marker in Colorectal Cancer
Preoperative WBC Count and Prognosis
Several studies have highlighted the significance of preoperative WBC counts in colorectal cancer (CRC). High preoperative WBC counts are associated with poor prognosis and decreased overall survival (OS) and disease-free survival (DFS) . Specifically, a high WBC count correlates with an immunosuppressive tumor microenvironment, characterized by increased regulatory T cells, CD68+ macrophages, and CD66b+ neutrophils, and decreased CD8+ T cells .
Post-Treatment WBC Count Changes
Post-treatment changes in WBC counts also provide prognostic information. For instance, adjuvant chemotherapy significantly decreases the counts of lymphocytes (LY), neutrophils (NE), and total WBCs, while surgery alone does not significantly affect these counts . An increased post/pre-treatment NE ratio is associated with poorer prognosis, indicating that monitoring WBC counts before and after treatment can be crucial for patient management .
WBC Count and Cancer Incidence
Association with Colorectal Cancer
High WBC counts have been linked to an increased risk of colorectal cancer. In a study conducted at King Hussein Medical Center, 17.4% of CRC patients exhibited leukocytosis (high WBC count), suggesting a potential role of WBC count as an inflammatory marker in CRC .
Risk of Venous Thromboembolism
Elevated WBC counts measured before cancer development are associated with a higher risk of venous thromboembolism (VTE) in cancer patients, but not in cancer-free individuals. This suggests that leukocytes may play a causal role in cancer-related VTE rather than merely reflecting inflammation .
WBC Count in Other Cancers
Lung Cancer
In lung cancer, elevated WBC counts are significantly associated with increased risk, particularly among smokers and never-smoking women. The risk is primarily driven by elevated neutrophil fractions, indicating that WBC count could be a marker for lung cancer risk .
Gastric Cancer
Higher WBC levels are also a risk factor for gastric cancer, especially in individuals with Helicobacter pylori infection. The incidence of gastric cancer increases linearly with higher WBC levels, suggesting that WBC count could be used for risk stratification in gastric cancer .
Differential Leukocyte Counts in Cancer Management
Differential leukocyte counts, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils, provide additional prognostic information. For example, in resectable gastric cancers, pre-treatment NE and total WBC counts are negatively correlated with OS, while adjuvant chemotherapy significantly decreases basophil levels . These findings underscore the importance of differential leukocyte counts in cancer prognosis and management.
Conclusion
WBC count is a valuable prognostic marker in various cancers, including colorectal, lung, and gastric cancers. Elevated WBC counts are generally associated with poorer prognosis and increased cancer risk. Monitoring WBC counts before and after treatment can provide critical insights into patient outcomes and guide therapeutic decisions. Further research is needed to fully understand the mechanisms underlying these associations and to develop targeted interventions based on WBC count profiles.
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