Hu Jialing, Tang Luoyong, Cheng Yunqi, Liu Anwen, Huang Long
Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Oncol. 2022 Feb 2;11:754624. doi: 10.3389/fonc.2021.754624. eCollection 2021.
To explore the risk factors and predictive indexes of severe thrombocytopenia during concurrent radio-chemotherapy of nasopharyngeal carcinomas.
Retrospective analysis was performed from the hospitalized patients with nasopharyngeal carcinoma from August 2014 to July 2017, and induction chemotherapy and concurrent radio-chemotherapy were completed. According to the lowest platelet count during concurrent chemotherapy, patients were divided into observation and control groups. General information and laboratory examinations were recorded and analyzed by univariate analysis, multivariate regression analysis, and ROC curve analysis.
Factors, including age, PLT, IBIL, APTT at first visit, WBC, RBC, HGB, PLT, NEUT, APTT, IBIL, FFA, Crea, and urea before radio-chemotherapy, which are significant in univariate analysis into multivariate regression analysis, were taken. It turned out that RBC (OR = 10.060, 95% CI 2.679-37.777, p = 0.001), PLT (OR = 1.020, 95% CI 1.006-1.034, p = 0.005), and IBIL (OR = 0.710, 95% CI 0.561-0.898, p = 0.004) are independent predictors of severe TP in NPC. ROC analysis showed that the AUC of RBC, IBIL, PLT, and AGE is 0.746 (p < 0.001), 0.735 (p < 0.001), 0.702 (p = 0.001), and 0.734 (p < 0.001). New variables called joint predictors were calculated by a regression equation (Y = 2.309 * RBC - 0.343 * IBIL + 0.02 * PLT - 10.007), the AUC of which is 0.8700 (p < 0.001); best truncation value is >5.87 mmol/l.
Lower RBC, PLT, and higher IBIL before concurrent radio-chemotherapy are independent risk factors causing severe TP during concurrent radio-chemotherapy of NPC. The RBC, PLT, and IBIL before concurrent radio-chemotherapy and joint predictor have a good predictive value to evaluate the risk of severe TP during concurrent radio-chemotherapy of NPC.
探讨鼻咽癌同步放化疗期间严重血小板减少的危险因素及预测指标。
回顾性分析2014年8月至2017年7月住院的鼻咽癌患者，这些患者均完成了诱导化疗及同步放化疗。根据同步化疗期间的最低血小板计数，将患者分为观察组和对照组。记录一般资料及实验室检查结果，并进行单因素分析、多因素回归分析及ROC曲线分析。
将单因素分析中有意义的因素，包括年龄、初诊时PLT、IBIL、APTT、同步放化疗前WBC、RBC、HGB、PLT、NEUT、APTT、IBIL、FFA、Crea及尿素纳入多因素回归分析。结果显示，RBC（OR = 10.060，95%CI 2.679 - 37.777，p = 0.001）、PLT（OR = 1.020，95%CI 1.006 - 1.034，p = 0.005）及IBIL（OR = 0.710，95%CI 0.561 - 0.898，p = 0.004）是鼻咽癌严重血小板减少的独立预测因素。ROC分析显示，RBC、IBIL、PLT及AGE的AUC分别为0.746（p < 0.001）、0.735（p < 0.001）、0.702（p = 0.001）及0.734（p < 0.001）。通过回归方程（Y = 2.309 * RBC - 0.343 * IBIL + 0.02 * PLT - 10.007）计算出联合预测指标这一新变量，其AUC为0.8700（p < 0.001）；最佳截断值为>5.87 mmol/l。
同步放化疗前较低的RBC、PLT及较高的IBIL是鼻咽癌同步放化疗期间导致严重血小板减少的独立危险因素。同步放化疗前的RBC、PLT、IBIL及联合预测指标对评估鼻咽癌同步放化疗期间严重血小板减少的风险具有较好的预测价值。
