吉西他滨治疗胰腺或胆道癌患者的最大化学发光强度可预测严重中性粒细胞减少症。
The maximum chemiluminescence intensity predicts severe neutropenia in gemcitabine-treated patients with pancreatic or biliary tract cancer.
机构信息
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Department of Biostastics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
出版信息
Cancer Chemother Pharmacol. 2018 Dec;82(6):953-960. doi: 10.1007/s00280-018-3685-6. Epub 2018 Sep 14.
PURPOSE
To assess the predictive ability of the maximum chemiluminescence intensity (CI) for severe neutropenia (SN) during neoadjuvant chemo(radio)therapy [NAC(RT)] in patients with advanced pancreatic or biliary tract cancer.
METHODS
Clinicopathological variables and blood test data before NAC(RT) were evaluated in 64 patients with advanced pancreatic or biliary tract cancer who received gemcitabine plus tegafur/gimeracil/oteracil as NAC(RT).
RESULTS
Thirty-nine patients (60.9%) developed Grade 3-4 SN. The median time between commencing NAC(RT) and the onset of SN was 15 (range 10-36) days. SN occurred during the NAC period, not the RT period. The CI, neutrophil count, serum interleukin-6 level, C-reactive protein level, complement C3 titer, serum complement titer, and 50.0% hemolytic unit of complement before NAC(RT) were significantly lower in patients with SN than in those without SN (P < 0.05). Multivariate analysis confirmed the CI to be the sole independent predictor of SN (P < 0.05). The optimal threshold for the CI was 46,000 RLU/s. The sensitivity and specificity were 46.2% and 80.0%, respectively. Majority of the patients (81.8%) with a low CI before NAC(RT) experienced SN during NAC(RT).
CONCLUSIONS
CI before NAC(RT) predicts SN during NAC(RT) in patients with advanced pancreatic or biliary tract cancer.
目的
评估新辅助化疗（NAC）期间最大化学发光强度（CI）对晚期胰腺或胆道癌患者严重中性粒细胞减少症（SN）的预测能力。
方法
对 64 例接受吉西他滨联合替加氟/尿嘧啶/奥替拉西作为 NAC 的晚期胰腺或胆道癌患者的临床病理变量和 NAC 前的血液检查数据进行评估。
结果
39 例（60.9%）发生 3-4 级 SN。从开始 NAC 到 SN 发作的中位时间为 15 天（范围 10-36 天）。SN 发生在 NAC 期间，而不是 RT 期间。与无 SN 患者相比，SN 患者的 CI、中性粒细胞计数、血清白细胞介素-6 水平、C 反应蛋白水平、补体 C3 滴度、血清补体滴度和 50.0%补体溶血单位在 NAC 前均显著降低（P<0.05）。多变量分析证实 CI 是 SN 的唯一独立预测因子（P<0.05）。CI 的最佳阈值为 46,000 RLU/s。灵敏度和特异性分别为 46.2%和 80.0%。大多数 NAC 前 CI 较低的患者（81.8%）在 NAC 期间发生 SN。
结论
NAC 前的 CI 可预测晚期胰腺或胆道癌患者 NAC 期间的 SN。
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