Chen Z, Chen W, Wang J, Zhu M, Zhuang Z
Department of Clinical Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Intern Med J. 2015 Aug;45(8):854-9. doi: 10.1111/imj.12786.
Increasing evidence suggests that neutrophils play a critical role in tumorigenesis, tumour cell proliferation and metastasis. The prognostic significance of such inflammation-associated markers has been explored in different cancers.
To evaluate the prognostic effect of baseline neutrophil counts and nadir neutrophils on advanced gastric cancer (AGC) patients who were treated with two different chemotherapy regimens in our institution.
Data were collected retrospectively for 260 AGC patients treated between 1 February 2009 and 31 December 2011. The prognostic effect of baseline neutrophil counts and nadir neutrophils on AGC patients was evaluated.
Approximately 79% of the patients experienced neutropenia during chemotherapy. The median survival was 369 days for patients with neutrophil counts ≤7.5 × 10(9) /L and 326 days for patients with neutrophil counts >7.5 × 10(9) /L (P < 0.001).The median survival was 340 days for patients with no neutropenia (grade 0), 422 days for patients with mild neutropenia (grade 1-2) and 339 days for patients with severe neutropenia (grade 3-4) (P < 0.001).The adjusted hazard ratios (HR) for mild and severe neutropenia compared with absent neutropenia were 0.572 (P = 0.002) and 1.246 (P = 0.219) respectively. Furthermore, it was suggested that pretreatment baseline neutrophil counts ≤7.5 × 10(9) /L may be an independent predictor (HR = 0.683; P = 0.005). We also observed that other factors were independently associated with worse survival, such as higher performance status, stage IV and the presence of ascites.
Our findings suggest that baseline neutrophil count and chemotherapy-induced neutropenia can be conveniently available as clinical biomarkers in AGC. Mild myelosuppression in patients with AGC most likely leads to better overall survival, whereas a high baseline neutrophil count may be associated with a worse prognosis.
越来越多的证据表明，中性粒细胞在肿瘤发生、肿瘤细胞增殖和转移中起关键作用。这种炎症相关标志物的预后意义已在不同癌症中得到探讨。
评估基线中性粒细胞计数和中性粒细胞最低点对在我院接受两种不同化疗方案治疗的晚期胃癌（AGC）患者的预后影响。
回顾性收集2009年2月1日至2011年12月31日期间接受治疗的260例AGC患者的数据。评估基线中性粒细胞计数和中性粒细胞最低点对AGC患者的预后影响。
约79%的患者在化疗期间出现中性粒细胞减少。中性粒细胞计数≤7.5×10⁹/L的患者中位生存期为369天，中性粒细胞计数>7.5×10⁹/L的患者中位生存期为326天（P<0.001）。无中性粒细胞减少（0级）的患者中位生存期为340天，轻度中性粒细胞减少（1-2级）的患者中位生存期为422天，重度中性粒细胞减少（3-4级）的患者中位生存期为339天（P<0.001）。与无中性粒细胞减少相比，轻度和重度中性粒细胞减少的校正风险比（HR）分别为0.572（P=0.002）和1.246（P=0.219）。此外，提示预处理基线中性粒细胞计数≤7.5×10⁹/L可能是一个独立预测因素（HR=0.683；P=0.005）。我们还观察到其他因素与较差的生存率独立相关，如较高的体能状态、IV期和腹水的存在。
我们的研究结果表明，基线中性粒细胞计数和化疗诱导的中性粒细胞减少可作为AGC方便可用的临床生物标志物。AGC患者的轻度骨髓抑制最有可能导致更好的总生存期，而高基线中性粒细胞计数可能与较差的预后相关。
