血红蛋白与红细胞分布宽度比值对口腔鳞状细胞癌化疗敏感性及预后的预测价值  

Predictive value of hemoglobin/red blood cell distribution width ratio for chemosensitivity and prognosis of oral squamous cell carcinoma

作　　者：徐小兵 张红英 范新德 XU Xiaobing;ZHANG Hongying;FAN Xinde(Department of Clinical Laboratory,Guangyuan Traditional Chinese Medicine Hospital,Guangyuan,Sichuan 628000,China)

机构地区：[1]广元市中医医院检验科,四川广元628000

出　　处：《国际检验医学杂志》2025年第9期1082-1086,共5页International Journal of Laboratory Medicine

基　　金：四川省卫生健康委医学科技项目(21PJ201)。

摘　　要：目的探讨血红蛋白与红细胞分布宽度比值(Hb/RDW)与口腔鳞状细胞癌(OSCC)患者化疗敏感性、预后的关系。方法选取2017年1月至2021年1月该院收治的150例晚期OSCC患者纳入研究组,选取同期该院诊治非OSCC的其他口腔疾病患者150例纳入对照组,另选取同期在该院行健康体检的100例体检健康者纳入健康组。OSCC患者进行化疗治疗,采用全自动血液分析仪检测血常规指标水平,计算Hb/RDW。比较两组患者Hb、RDW、Hb/RDW,分析Hb/RDW比值与OSCC患者化疗敏感性、预后的关系。采用多因素Logistic回归分析影响OSCC患者化疗敏感性的影响因素。结果研究组患者Hb、Hb/RDW显著低于对照组与健康组(P<0.05),RDW水平显著高于对照组与健康组(P<0.05)。以OSCC患者Hb/RDW比值中位数(8.16)为界值将OSCC患者分为Hb/RDW高比值组和Hb/RDW低比值组。Hb/RDW高比值组患者化疗总有效率为70.67%,高于Hb/RDW低比值组患者化疗总有效率(53.33%,P<0.05)。根据化疗敏感性将研究组患者分为敏感组(n=103)和抵抗组(n=47)。抵抗组Ⅳ期、低分化、有淋巴结转移患者比例高于敏感组患者(P<0.05)。多因素Logistic回归分析显示,TNM分期Ⅳ期(OR=2.512,95%CI:1.588~3.973)、肿瘤低分化程度(OR=2.237,95%CI:1.427~3.938)、有淋巴结转移(OR=2.821,95%CI:1.607~4.951)、Hb/RDW≤8.16(OR=3.540,95%CI:2.001~6.261)是OSCC患者化疗敏感性的危险因素(P<0.05)。Hb/RDW高比值组OSCC患者随访3年的生存率为74.67%(56/75),Hb/RDW低比值组3年的生存率为58.67%(44/75),两组患者预后3年生存率比较,差异有统计学意义(χ^(2)=4.320,P=0.038)。结论Hb/RDW在OSCC患者中呈低表达,且与患者化疗敏感性和预后有关,有望作为OSCC患者化疗敏感性和预后预测的潜在标志物。Objective To explore the relationship between hemoglobin/red blood cell distribution width ratio(Hb/RDW)and chemotherapy sensitivity and prognosis in patients with oral squamous cell carcinoma(OSCC).Methods A total of 150 patients with advanced OSCC admitted to the hospital from January 2017 to January 2021 were selected into the study group.150 patients with other oral diseases who were diagnosed and treated for non-OSCC in the hospital during the same period were selected into the control group.Another 100 healthy subjects who underwent physical examination in the hospital during the same period were selected into the healthy group.Patients with OSCC were treated with chemotherapy,and blood routine indexes were detected by automatic blood analyzer,and Hb/RDW ratio was calculated.Hb,RDW and Hb/RDW ratio were compared between the two groups and the relationship between Hb/RDW ratio and the sensitivity and prognosis of OSCC patients with chemotherapy were analyzed.The factors affecting the sensitivity of OSCC patients to chemotherapy were explored by multivariate Logistic regression.Results Hb and Hb/RDW in the study group were significantly lower than those in the control group and the healthy group,and RDW levels were significantly higher than those in the control group and the healthy group(P<0.05).The patients with OSCC were divided into high Hb/RDW group and low Hb/RDW group using the median Hb/RDW ratio(8.16)as the cut off value.The total effective rate of chemotherapy in Hb/RDW high ratio group was 70.67%,which was higher than that in Hb/RDW low ratio group 53.33%(P<0.05).According to the sensitivity of chemoradiotherapy,the study group was divided into sensitive group(n=103)and resistant group(n=47).The proportion of patients with stageⅣ,low differentiation and lymph node metastasis in resistance group was higher than that in sensitive group(P<0.05).Multivariate Logistic regression analysis shows that TNM stageⅣ(OR=2.512,95%CI:1.588-3.973),low tumor differentiation(OR=2.237,95%CI:1.427-3.938),lymph nod

关 键 词：血红蛋白与红细胞分布宽度比值 口腔鳞状细胞癌 化疗敏感性 预后 

分 类 号：R446.1[医药卫生—诊断学] R739.8[医药卫生—临床医学]