非小细胞肺癌铂类药物基因敏感患者化疗前后血细胞参数与疗效相关性分析

Correlation between efficacy of platinum-based chemotherapy and changes of parameters in peripheral blood cells in NSCLC patients sensitive to platinum in pharmacogenomics

目的探讨非小细胞肺癌(NSCLC)铂类药物基因敏感患者化疗前后外周血细胞参数与临床疗效之间的相关性。方法检测54例NSCLC外周血铂类药物敏感基因患者,选择吉西他滨加顺铂(GP)化疗方案,定期检测患者化疗前后外周血细胞参数的变化,化疗四个周期后评价疗效。结果患者化疗第7 d WBC、MONO、LYM、PLT、PCT、LFR、RBC计数较化疗前差异有统计学意义(P<0.05),第10 d LYM、PLT、RET%、HFR、RBC计数较化疗前差异有统计学意义(P<0.05),13 d后MONO、LYM、PLT、PCT、LFR、MFR、RBC计数较化疗前差异有统计学意义(P<0.05);在整个监测期LYM、PLT、RBC三个参数化疗前后差异有统计学意义(P<0.05);治疗有效组与无效组比较:只有化疗13 d外周血细胞参数LYM化疗前后差异有统计学意义(P<0.01),其他血细胞参数与化疗前比较差异无统计学意义(P>0.05)。结论非小细胞肺癌(NSCLC)铂类药物基因敏感患者化疗前后外周血细胞参数中多参数都有变化,但只有淋巴细胞参数的变化对GP化疗疗效有参考意义,淋巴细胞低表达提示对GP化疗药物的敏感,是可作为NSCLC患者从铂类药物化疗中获益的观察指标。

Objective To explore the association between the efficacy of gemcitabine plus cisplatin （GP） and the changes of parameters in peripheral blood cells after platinum-based chemotherapy in patients with non-small cell lung cancer （ NSCLC ） who were platinum-sensitive in pharmaeogenomics. Methods Fifty-four NSCLC patients who were detected to be sensitive to platinum drug by gene mutation test were recruited and GP chemotherapy scheme was employed. The efficacy parameters, peripheral blood cells, before and after GP chemotherapy were regularly detected and recorded. The efficacy after four cycles of chemotherapy was evaluated. Results Compared with the parameters before the chemotherapy, statistically significant differences were found in the counts of WBC, MONO, LYM, PLT, PCT, LFR and RBC on the 7th day after the chemotherapy （ P〈0.05 ） , in the counts of LYM, PLT, RET%, HFR and RBC on the 10th day after the chemotherapy （P〈0.05） as well as in the counts of MONO, LYM, PLT, PCT, LFR, MFR and RBC on the 13th day after the chemotherapy （P〈0.05}. The counts of LYM, PLT and RBC showed persistent significant differences all through the trial compared with those before the chemotherapy （P〈0.05}. A comparison between the effective therapeutic group and the non-effective therapeutic group revealed that no statistically significant differences were found in the parameters of peripheral blood cells （ P〉0.05 ） except the counts of LYM on the 13th day after the chemotherapy （P〈0.01）. Conclusions For NSCLC patients sensitive to platinum in pharmaeogenomics, various parameters in peripheral blood cells show changes after GP chemotherapy, but only the change of lymphocyte has referential significance for evaluating the GP efficacy. The low level expression of lymphocyte is a sensitive predictive factor for GP chemotherapy. It can be used as an indicator for predicting the effects of the combination of gemcitabine chemotherapy and platinum-based adjuvant chemotherapy.