中性粒细胞减少、NLR指标及TNF-α、IL-8水平对早期宫颈癌放化疗的预后作用研究  

Study of the Prognostic Effect of Neutropenia,NLR,TNF-αand IL-8 in Early Cervical Cancer Undergoing Radiotherapy and Chemotherapy

作　　者：吴瑞杰 李婷 王海峰 王伟 Wu Ruijie;Li Ting;Wang Haifeng(Radiotherapy Department,Yuncheng Central Hospital,Yuncheng,Shanxi 044000,China)

机构地区：[1]运城市中心医院放疗科,妇科,山西运城044000

出　　处：《四川医学》2024年第6期634-637,共4页Sichuan Medical Journal

摘　　要：目的探讨中性粒细胞减少、NLR指标及TNF-α、IL-8水平在早期宫颈癌放化疗中的预后作用分析。方法选取2020年6月至2022年1月于我院就诊的宫颈鳞状细胞癌患者115例,对患者的基本资料、临床分期、病理结果等信息进行回顾性分析。患者均行根治性子宫切除术伴淋巴结切除术,并行术后辅助CCRT。在辅助CCRT治疗期间,每周对患者行血细胞计数测定,每周进行血清炎性因子的检测。根据是否有中性粒细胞减少分为A(中性粒细胞减少)、B(中性粒细胞未减少)两组,对两组患者临床资料进行比较,采用Cox回归模型检验影响预后的独立因素,Kaplan-Meier法进行生存分析。结果A组患者发生深基质入侵比例显著低于B组,A组发生淋巴血管空间侵犯比例显著高于B组,A组血清炎性因子TNF-α、IL-8水平明显优于对照组患者,差异均有统计学意义(P<0.05)。Kaplan-Meier曲线分析结果显示具有淋巴结转移的患者中中性粒细胞减少患者的无病生存率(DFS)相较无中性粒细胞减少患者增加(P=0.033),具有淋巴结转移的患者群中,A组无病生存率较B组增加(P<0.05)。Cox比例风险模型分析结果显示中性粒细胞减少与TNF-α、IL-8水平为复发的预后因素,差异有统计学意义(P<0.05)。结论辅助CCRT引起的中性粒细胞减少可能是宫颈癌复发的一个预后因素,建议在宫颈癌的临床治疗中,在骨髓抑制的安全范围内给予患者个体化CCRT剂量方案,同时定期监测患者血清炎性因子TNF-α、IL-8水平。Objectives To analyze the prognostic effect of neutropenia,NLR,TNF-αand IL-8 in early cervical cancer undergoing radiotherapy and chemotherapy.Methods From June 2020 to January 2022,115 patients with cervical squamous cell carcinoma who visited our hospital were selected for retrospective analysis of their basic data,clinical staging,pathological results,and other information.All patients underwent radical hysterectomy with lymph node dissection,and postoperative adjuvant CCRT.During the auxiliary CCRT treatment period,patients were subjected to weekly blood cell counts measurements.Serum inflammatory factor tests were conducted weekly.According to whether there was neutropenia,they were divided into group A(neutropenia)and group B(no neutropenia).Clinical data were compared.Cox regression model was used to test independent factors affecting prognosis,and Kaplan-Meier method was used for survival analysis.Results The proportion of deep matrix invasion in group A was significantly lower than that in group B.The proportion of lymphatic vessel spatial invasion in group A was significantly higher than that in group B.And serum inflammatory factor TNF-αand IL-8 in group A were significantly higher than that of group B with statistically significant differences(P<0.05).The Kaplan-Meier curve analysis results showed that lymph node metastasis patients with neutropenia had an increased disease-free survival rate(DFS)compared to patients without neutropenia(P=0.033).In the group of patients with lymph node metastasis,DFS in group A increased compared to patients in group B(P<0.05).Cox proportional risk model analysis results show that neutropenia,TNF-αand IL-8 that were prognostic factors for recurrence with statistical significance(P<0.05).Conclusion The neutropenia caused by assisted CCRT may be a prognostic factor for cervical cancer recurrence.It is recommended to provide individualized CCRT dosage regimens within the safe range of bone marrow suppression in the clinical treatment of cervical cancer,while regularly

关 键 词：宫颈癌 辅助同步放化疗 中性粒细胞 预后 血清炎性因子 

分 类 号：R737.33[医药卫生—肿瘤]