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预测单核细胞和淋巴细胞对实体瘤化疗引起的重度中性粒细胞减少症中短期中性粒细胞变化的价值。

Predictive value of monocytes and lymphocytes for short-term neutrophil changes in chemotherapy-induced severe neutropenia in solid tumors.

机构信息

Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuma Road 420, Fuzhou, Fujian, People's Republic of China.

出版信息

Support Care Cancer. 2020 Mar;28(3):1289-1294. doi: 10.1007/s00520-019-04946-3. Epub 2019 Jun 25.

Abstract

PURPOSE

To explore whether monocytes, lymphocytes, and platelets have a predictive value for short-term neutrophil changes in patients with severe neutropenia (SN) induced by chemotherapy.

METHODS

Complete blood counts (CBC) were collected from a total of 62 patients with chemotherapy-induced SN from December 2013 to March 2018. CBCs at intervals of 1 day, 2 days, 3 days, 4 days, and 5 days were recorded, and logistic regression analyses were performed to determine whether the monocyte percentage (MP), absolute monocyte count (AMC), lymphocyte percentage (LP), absolute lymphocyte count (ALC), or platelet count (PC) were correlated with short-term neutrophil changes. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for parameters with a P value < 0.05.

RESULTS

The MP was significantly correlated with changes in neutrophils for intervals of 1 to 5 days, while the LP was significantly correlated with changes in neutrophils for intervals of 2 to 5 days. A cutoff value of 6.5% for the MP yielded a sensitivity of 80%, a specificity of 88.6%, and an AUC of 0.908 for predicting an increase in neutrophils on the third day. A cutoff value of 14.75% for the LP yielded a sensitivity of 93.3%, a specificity of 70.3%, and an AUC of 0.812 for predicting an increase in neutrophils on the sixth day.

CONCLUSIONS

In chemotherapy-induced neutropenia patients, the MP is the best predictor of short-term neutrophil changes. Close monitoring and proper interpretation of the MP and LP are informative in managing chemotherapy-induced neutropenia.

摘要

目的

探讨化疗引起的严重中性粒细胞减少症(SN)患者的单核细胞、淋巴细胞和血小板是否对短期中性粒细胞变化具有预测价值。

方法

收集 2013 年 12 月至 2018 年 3 月共 62 例化疗引起的 SN 患者的全血细胞计数(CBC)。记录间隔 1 天、2 天、3 天、4 天和 5 天的 CBC,并进行逻辑回归分析,以确定单核细胞百分比(MP)、单核细胞绝对计数(AMC)、淋巴细胞百分比(LP)、淋巴细胞绝对计数(ALC)或血小板计数(PC)是否与短期中性粒细胞变化相关。对 P 值 < 0.05 的参数计算受试者工作特征(ROC)曲线下面积(AUC)。

结果

MP 与 1 至 5 天的中性粒细胞变化显著相关,而 LP 与 2 至 5 天的中性粒细胞变化显著相关。MP 的截断值为 6.5%,预测第 3 天中性粒细胞增加的灵敏度为 80%,特异性为 88.6%,AUC 为 0.908。LP 的截断值为 14.75%,预测第 6 天中性粒细胞增加的灵敏度为 93.3%,特异性为 70.3%,AUC 为 0.812。

结论

在化疗引起的中性粒细胞减少症患者中,MP 是短期中性粒细胞变化的最佳预测指标。密切监测和适当解释 MP 和 LP 有助于管理化疗引起的中性粒细胞减少症。

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