原发性支气管肺癌患者初发时淋巴细胞绝对数与预后的关系分析  

Relationship between the absolute lymphocyte count and the prognosis of patients with primary bronchogenic carcinoma

作　　者：陈洁[1,2] 楼朝阳[1] 徐天骄[1] 郭东桃[1] 余晶晶[1] 王刚[1] 

机构地区：[1]中国人民解放军第477医院肿瘤科,湖北襄阳430070 [2]第二军医大学长海医院血液科,上海200433

出　　处：《徐州医学院学报》2012年第10期647-651,共5页Acta Academiae Medicinae Xuzhou

基　　金：国家自然科学基金（81170499）

摘　　要：目的分析原发性支气管肺癌患者发病时淋巴细胞绝对数（absolutelymphocytecount，ALC）与临床疗效、无病生存期（DFS）和总生存时间（os）的关系，探讨ALC作为肺癌患者预后判断的可行性。方法回顾性分析86例肺癌患者的临床病理学资料和实验室检查，对初发ALC与不同治疗方式的有效率、DFS和OS的关系进行统计学分析。结果本组肺癌临床化疗、放疗的总有效率为57．83％，疾病初发ALC≥1．5×10^9／L的患者临床疗效较好，有效率明显高于ALC〈1．5×10^9／L的患者（P〈0．01）。ALC与单纯化疗及联合放化疗的疗效密切相关，而与手术、放疗的疗效无关。ALC水平与患者的年龄、肺癌组织学类型无关，但初发ALC高的肺癌患者，其临床分期偏向于Ⅰ～Ⅱ期。Kaplan—Meier生存曲线和log—rank分析显示，初发ALC水平与接受化疗肺癌患者的DFS和OS密切相关，初发ALC高水平的化疗患者DFS和OS明显延长。结论肺癌患者初发ALC水平与临床化疗疗效和化疗患者的生存期密切相关，提示疾病初发时高水平的ALC能够保护机体免疫系统功能，对减轻化疗药物的毒副反应、提高患者抗肿瘤能力有积极的意义。ALC有可能成为肺癌患者化疗后预后判断的独立因素。Objective To analyze the relationship between the absolute lymphocyte count （ALC） and the outcome, disease - free survival （ DFS）, overall survival （OS） of patients with primary bronchogenic carcinoma, and to evaluate the possibility that ALC is a prognosis marker for lung cancer patients. Methods Clinical and laboratory data of 86 lung cancer patients were collected, and the relationship between the ALC and the therapeutic outcome, DFS, OS of lung cancer patients were analyzed retrospectively and statistically. Results Total therapeutic effective rate was 57.83 % in this group of lung cancer patients. The patients with high ALC levels （ ≥1.5×10^9） had higher effective rate than those with low ALC levels （ 〈 1.5 × 10^9/L） （P 〈0.01 ）. ALC levels were correlated with outcome of chemotherapy or combined chemotherapy, but not with operation and radiotherapy. ALC levels were also correlated with clinicopathological stages of lung cancer but not with the patients＇ age and cancer histological types. By Kaplan - Meier survival curve and log- rank analysis, it was found that the patients with high ALC levels （≥ 1.5 × 10^9/L） had longer DFS and OS, com- pared with those with low ALC levels. Conclusion ALC level in patients with lung cancer is intimately correlated to the chemotherapeutic outcome and the survival time of the patients who receive chemotherapy, suggesting that high levels of ALC can protect the inmmne function of cancer patients and enhance the chemotherapeutic efficacy. ALC may become a possible independent and significant marker for judgment of prognosis in patients with lung cancer.

关 键 词：肺肿瘤 原发性支气管肺癌 淋巴细胞绝对数 临床疗效 生存期 预后 

分 类 号：R734.2[医药卫生—肿瘤]