Department of Colorectal Surgery, Good Hope Hospital, Rectory Road, Sutton Coldfield, Birmingham, UK.
Int J Colorectal Dis. 2010 Jun;25(6):723-9. doi: 10.1007/s00384-010-0886-9. Epub 2010 Feb 23.
This study aimed to determine differences in neutrophil levels between those receiving long-course neoadjuvant chemoradiotherapy (nCXRT) and those proceeding straight to surgery (StS) for rectal cancer, and in those who developed serious septic events within 30 post-operative days within each group.
Patients undergoing elective surgery between 2006 and 2008 were retrospective reviewed. Some 38 received nCXRT, and 46 proceeded StS. Statistical techniques included repeated measures analyses.
There was no significant difference in serious 30-day septic rates (anastomotic leaks, pelvic abscess or generalised sepsis) between treatment groups (nCXRT, 11%; StS, 13%; p = 1.000). Neutrophil levels in the nCXRT group fell significantly and remained lower throughout treatment than those proceeding StS (p < 0.001 within groups, p < 0.001 between groups). The difference in means of the treatment groups was different for those with sepsis than for those without, and the difference in means of those with sepsis and those without is very different for the two treatment groups (p = 0.018).
Chemoradiotherapy reduced neutrophil levels throughout treatment, and post-operative septic patients in this group had even lower levels. Further studies are warranted to fully assess the relationship of neutrophil levels to sepsis, using standardised definitions of sepsis.
本研究旨在确定接受长程新辅助放化疗（nCXRT）和直接手术（StS）治疗直肠癌的患者之间中性粒细胞水平的差异，以及每组术后 30 天内发生严重脓毒症事件的患者之间中性粒细胞水平的差异。
回顾性分析 2006 年至 2008 年期间接受择期手术的患者。其中 38 例接受 nCXRT，46 例直接进行 StS。统计技术包括重复测量分析。
两组治疗后 30 天内严重脓毒症发生率（吻合口漏、盆腔脓肿或全身性败血症）无显著差异（nCXRT 组为 11%，StS 组为 13%，p=1.000）。nCXRT 组的中性粒细胞水平在治疗期间显著下降，并持续低于直接进行 StS 的患者（组内 p<0.001，组间 p<0.001）。两组间中性粒细胞水平的差异在脓毒症患者与非脓毒症患者之间不同，而脓毒症患者与非脓毒症患者之间的差异在两组之间也非常不同（p=0.018）。
放化疗治疗期间降低了中性粒细胞水平，而该组术后脓毒症患者的水平更低。需要进一步研究使用脓毒症的标准化定义，全面评估中性粒细胞水平与脓毒症的关系。
