Zhao Qianqian, Xu Xiaoqing, Yue Jinbo, Zhu Kunli, Feng Rui, Jiang Shumei, Qi Zhonghua, Wang Renben
School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong Province, People's Republic of China Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Jinan, Shandong Province, People's Republic of China.
Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Jinan, Shandong Province, People's Republic of China.
Therap Adv Gastroenterol. 2017 Feb;10(2):231-241. doi: 10.1177/1756283X16685557. Epub 2016 Dec 29.
Peripheral blood lymphocytes play an important role in antitumour immunity. We examined the relationship between the minimum absolute lymphocyte counts (Min ALCs) during radiotherapy (RT) and clinical outcomes in patients with hepatocellular carcinoma (HCC).
Data from a total of 69 HCC patients who had received RT were retrospectively analysed. Peripheral blood lymphocytes were measured before RT, weekly during RT and after RT. Regression and mixed-effect models were used to assess the relationships with and potential predictors of overall survival (OS). Receiver-operating characteristic (ROC) curve analysis was used to define optimal cut-off points of continuous variables for outcomes.
The median follow up was 30 months (range, 4-68 months). The median survival time (MST), 1-year OS rate and 2-year OS rate of the whole group were 25 months, 51% and 39%, respectively. The average circulating lymphocyte counts declined during RT (1493.19 503.48 cells/µl, < 0.001). A lower Min ALC was associated with worse OS ( = 0.001), with a cut-off value of 450 cells/µl (sensitivity and specificity, 50% and 70.6%, respectively). The MSTs, 1-year OS rates and 2-year OS rates were 15 months 47 months, 27% 78% and 4% 71% for patients with relatively lower (⩽450 cells/µl) and higher Min ALCs (>450 cells/µl), respectively ( < 0.001). After adjusting for potential confounders, multivariate Cox regression analysis demonstrated that Min ALC independently predicted patients' OS (HR, 0.32; 95% CI, 0.15-0.69).
Lower Min ALCs during RT may act as a worse prognostic factor for HCC after RT.
外周血淋巴细胞在抗肿瘤免疫中发挥重要作用。我们研究了肝细胞癌（HCC）患者放疗（RT）期间的最低绝对淋巴细胞计数（Min ALCs）与临床结局之间的关系。
回顾性分析了总共69例接受RT的HCC患者的数据。在RT前、RT期间每周以及RT后测量外周血淋巴细胞。采用回归和混合效应模型评估与总生存期（OS）的关系及潜在预测因素。采用受试者操作特征（ROC）曲线分析来确定连续变量用于结局的最佳截断点。
中位随访时间为30个月（范围4 - 68个月）。全组的中位生存时间（MST）、1年OS率和2年OS率分别为25个月、51%和39%。RT期间循环淋巴细胞计数平均下降（1493.19±503.48细胞/µl，P<0.001）。较低的Min ALC与较差的OS相关（P = 0.001），截断值为450细胞/µl（敏感性和特异性分别为50%和70.6%）。Min ALC相对较低（⩽450细胞/µl）和较高（>450细胞/µl）的患者的MST、1年OS率和2年OS率分别为15个月对47个月、27%对78%和4%对71%（P<0.001）。在调整潜在混杂因素后，多因素Cox回归分析表明Min ALC独立预测患者的OS（HR，0.32；95%CI，0.15 - 0.69）。
RT期间较低的Min ALC可能是HCC患者RT后预后较差的一个因素。
