Tian Xiufang, Hou Yong, Guo Jianping, Wu Haiyan, Nie Limin, Wang Hang, Zhang Yan, Lv Yajuan
Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China.
Department of Oncology, Maternal and Child Health Care Hospital of Zibo, Zibo, Shandong, China.
Front Oncol. 2023 Mar 7;13:1096386. doi: 10.3389/fonc.2023.1096386. eCollection 2023.
Radiotherapy usually leads to a decrease in the total number of lymphocytes in patients with esophageal cancer. The factors that causing lymphopenia and the clinical significance of lymphopenia are studied in this article.
110 patients with esophageal squamous cell carcinoma who had undergo intensity-modulated radiation therapy were enrolled. Statistical methods were used to analyze the correlation between lymphopenia and total survival in patients with esophageal cancer during radiotherapy, and analyze the correlations between nutritional factors and lymphopenia.
There were 11 patients with the lowest lymphocyte value with level 1-2 during radiotherapy, accounting for 10% of all the patients, and 110 patients with level 3-4, accounting for 90% of all the patient. In all the enrolled patients, the incidence of lymphocyte nadir G1, G2, G3 and G4 MinALC during radiotherapy accounted for 0.91%, 9.09%, 62.73% and 27.27%, respectively.KM survival analysis showed that the overall survival of patients in the group (MinALC ≤ 0.41×10/L) was significantly lower than that of the patients in the other group (MinALC>0.43×10/L). Nutritional indicators were positively correlated with the decline degree of lymphocytes. The minimal value of lymphocyte can predict the occurrence of grade 3-4 radiation pneumonitis.
Lymphopenia induced by radiotherapy can predict survival and radiation pneumonitis. Nutritional factors such as hemoglobin and albumin were positively correlated with total lymphocytes numbers induced by radiotherapy.
放射治疗通常会导致食管癌患者淋巴细胞总数减少。本文研究了导致淋巴细胞减少的因素及淋巴细胞减少的临床意义。
纳入110例行调强放射治疗的食管鳞状细胞癌患者。采用统计学方法分析食管癌患者放疗期间淋巴细胞减少与总生存的相关性，以及营养因素与淋巴细胞减少的相关性。
放疗期间淋巴细胞值最低为1 - 2级的患者有11例，占所有患者的10%，3 - 4级的患者有110例，占所有患者的90%。在所有纳入患者中，放疗期间淋巴细胞最低点G1、G2、G3和G4的最小绝对淋巴细胞计数（MinALC）发生率分别为0.91%、9.09%、62.73%和27.27%。Kaplan - Meier生存分析显示，MinALC≤0.41×10⁹/L组患者的总生存明显低于另一组（MinALC>0.43×10⁹/L）。营养指标与淋巴细胞下降程度呈正相关。淋巴细胞最小值可预测3 - 4级放射性肺炎的发生。
放疗引起的淋巴细胞减少可预测生存和放射性肺炎。血红蛋白和白蛋白等营养因素与放疗诱导的总淋巴细胞数量呈正相关。
