外周血嗜酸性粒细胞检测对口腔鳞状细胞癌术后的预后意义

The prognostic significance of peripheral blood eosinophilia in oral squamous cell carcinoma after surgery

目的探讨外周血嗜酸性粒细胞差异对口腔鳞状细胞癌术后患者的预后意义。方法回顾性分析2010年1月至2012年12月绍兴市人民医院口腔科住院并行手术治疗的口腔鳞状细胞癌患者62例,随访至2014年12月。计算嗜酸性粒细胞百分比及计数的均值,将患者分为大于等于均值组及小于均值组,比较两组患者术后的复发率,并将两组患者进行生存分析及多因素COX回归分析。结果按嗜酸性粒细胞计数均值分组,两组患者复发率及生存率差别均有统计学意义(P值分别为0.002和0.016)。按嗜酸性粒细胞百分比均值分组,两组患者复发率差异有统计学意义(P=0.005),生存率差异无统计学意义(P=0.253)。通过单因素生存分析,嗜酸性粒细胞计数是患者生存率的影响因素(P=0.030),多因素COX回归分析,嗜酸性粒细胞百分比与计数对生存率均无明显影响(P>0.05),而年龄及复发与否是患者生存率的影响因素(P<0.05)。结论口腔鳞状细胞癌术后早期患者外周血嗜酸性粒细胞百分比及计数减少提示该病复发的可能性大;尚无足够证据表明外周血嗜酸性粒细胞的改变将影响患者总体生存率。

Objective To discuss the prognostic significance of peripheral blood eosinophilia in oral squamous cell carcinoma after surgery. Methods 62 cases of oral squamous cell carcinoma who hospitalized in our hospital from January 2010 to December 2012 were retrospectively evaluated, and followed up until December 2014. The mean of the eosinophil percentage and count was calculated. Patients were divided into two groups. Results in one of the groups were no less than the mean, while those in the other group were less than the mean. Postoperative recurrence rates of the two groups were compared, and the survival analysis and multivariate COX regres- sion analysis were performed on the two groups of patients. Results According to the eosinophil count mean grouping, there was statis- tically significant difference in both recurrence rate and survival rate between the two groups （P= 0.002 and 0.016 respectively）. Ac- cording to the eosinophil percentage mean grouping, the two groups＇ recurrence rates were significantly different（P= 0.005） , yet no statistically significant difference was found in two groups＇ overall survival rate （P= 0.0253）. By the single factor survival analysis, eosinophil count was a factor affecting the survival rate（P=0.03）, and the muhiariable COX regression analysis showed that eosinophil percentage and count had no obvious effect on the overall survival rate（P〉0.05）, but age and recurrence or not may affect the overall survival rate（ P〈0.05 ）. Conclusion Peripheral eosinophil percentage and count reduce may imply postoperative recurrence of the oral squamous cell carcinoma ; But there is no enough evidence showing that the change of peripheral blood eosinophilia will affect patients overall survival rate.