化疗期间血液学参数对癌症患者发热性中性粒细胞减少症的预测价值。

Predictive value of peri-chemotherapy hematological parameters for febrile neutropenia in patients with cancer.

作者信息

Jia Hongyuan, Liang Long, Chen Xue, Zha Wenzhong, Diao Wei, Zhang Wei

机构信息

Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.

Cancer Center, Sichuan Taikang Hospital, Chengdu, Sichuan, China.

出版信息

Front Oncol. 2024 Aug 19;14:1380195. doi: 10.3389/fonc.2024.1380195. eCollection 2024.

DOI:10.3389/fonc.2024.1380195

PMID:39224807

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11366635/

Abstract

OBJECTIVE

The aim of this study was to compare hematological parameters pre- and early post-chemotherapy, and evaluate their values for predicting febrile neutropenia (FN).

METHODS

Patients diagnosed with malignant solid tumors receiving chemotherapy were included. Blood cell counts peri-chemotherapy and clinical information were retrieved from the hospital information system. We used the least absolute shrinkage and selection operator (LASSO) method for variable selection and fitted selected variables to a logistic model. We assessed the performance of the prediction model by the area under the ROC curve.

RESULTS

The study population consisted of 4,130 patients with common solid tumors receiving a three-week chemotherapy regimen in Sichuan Cancer Hospital from February 2019 to March 2022. In the FN group, change percentage of neutrophil count decreased less (-0.02, CI: -0.88 to 3.48 vs. 0.04, CI: -0.83 to 2.24). Among hematological parameters, lower post-chemotherapy lymphocyte count (OR 0.942, CI: 0.934-0.949), change percentage of platelet (OR 0.965, CI: 0.955-0.975) and higher change percentage of post-chemotherapy neutrophil count (OR 1.015, CI: 1.011-1.018), and pre-chemotherapy NLR (OR 1.002, CI: 1.002-1.002) predicted an increased risk of FN. These factors improved the predicting model based on clinical factors alone. The AUC of the combination model was 0.8275.

CONCLUSION

Peri-chemotherapy hematological markers improve the prediction of FN.

摘要

目的

本研究旨在比较化疗前和化疗早期的血液学参数，并评估其对预测发热性中性粒细胞减少症（FN）的价值。

方法

纳入接受化疗的恶性实体瘤患者。从医院信息系统中检索化疗期间的血细胞计数和临床信息。我们使用最小绝对收缩和选择算子（LASSO）方法进行变量选择，并将选定变量拟合到逻辑模型中。我们通过ROC曲线下面积评估预测模型的性能。

结果

研究人群包括2019年2月至2022年3月在四川省肿瘤医院接受为期三周化疗方案的4130例常见实体瘤患者。在FN组中，中性粒细胞计数变化百分比下降较少（-0.02，CI：-0.88至3.48 vs. 0.04，CI：-0.83至2.24）。在血液学参数中，化疗后淋巴细胞计数较低（OR 0.942，CI：0.934 - 0.949）、血小板变化百分比（OR 0.965，CI：0.955 - 0.975）以及化疗后中性粒细胞计数变化百分比较高（OR 1.015，CI：1.011 - 1.018）和化疗前NLR（OR 1.002，CI：1.002 - 1.002）预测FN风险增加。这些因素改进了仅基于临床因素的预测模型。联合模型的AUC为0.8275。