小细胞肺癌患者血清铁蛋白、红细胞沉降率和红细胞平均指数水平与预后的关系

Relationship between serum ferritin, erythrocyte sedimentation rate, mean corpuscular indexes and prognosis in patients with small cell lung cancer

目的探索血清铁蛋白（SF）、红细胞沉降率（ESR）和红细胞平均指数水平[平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）、平均红细胞血红蛋白浓度（MCHC）]对小细胞肺癌（SCLC）患者预后评估的临床价值。方法收集2013年1月至2016年10月南通大学附属海安县人民医院收治的72例SCLC患者作为SCLC组，同期选取健康体检者80例作为对照组。检测SCLC组和对照组研究对象血清SF、ESR和红细胞平均指数水平，并分析其与SCLC临床特征、预后及生存时间的关系。结果SCLC组血清SF、ESR、MCV、MCH、MCHC水平分别为（309±59）μg／L、（16±4）mm／h、（104±12）fl、（32±4）pg和（307±21）g／L，对照组分别为（186±26）μg／L、（15±5）mm／h、（85±7）fl、（30±3）pg和（335±25）g／L，与对照组相比，SCLC患者在SF（t=14．168，P〈0．001）和MCV（t=6．143，P〈0．001）水平上显著增高，而MCHC（t=-4．220，P=0．003）水平显著降低，两组之间的ESR（t=1．931，P=0．102）和MCH（t=1．220，P=0．313）水平差异无统计学意义。SCLC患者血清SF、MCV水平与SCLC分期显著相关（t=-4．092，P=0．009；t=-4．985，P〈0．001）。多元logistic回归多因素分析显示，血清SF（OR=5．3l，95％凹为3．09-9．31，P〈0．001）和MCV（OR=1．78，95％C1为1．10-3．08，P=0．013）升高是SCLC的独立危险因素。生存分析显示，高SF组患者的中位生存时间显著低于低SF组患者（6个月：20个月；χ^2=6．556，P=0．001）。结论血清ESR、MCH和MCHC水平与SCLC无显著相关性，而血清SF和MCV在评估SCLC患者预后中具有重要临床意义。

Objective To explore the clinical value of serum ferritin （SF）, erythrocyte sedimentation rate （ESR） and erythrocyte average indexes [ mean corpuscular volume （MCV） , mean corpuscular hemoglobin （MCH）, mean corpuscular hemoglobin concentration （MCHC）] in the prognosis evaluation of patients with small cell lung cancer （SCLC）. Methods A total of 72 SCLC patients were enrolled in the Haian People＇s Hospital Affiliated to Nantong University from January 2013 to October 2016 （ SCLC group）, and 80 health controls were selected at the same time （ control group）. The levels of serum SF, ESR and erythrocyte average indexes in SCLC group and control group were detected, and their relationships with clinical features, prognosis and survival time were analyzed. Results The serum levels of SF, ESR, MCV, MCH and MCHC in SCLC pa- tients were （309 ＋59） μg/L, （16 ±4） mm/h, （104 ±12） fl, （32 ＋4） pg and （307 ±21） g/L, respectively. The serum levels of SF, ESR, MCV, MCH and MCHC in control group were （ 186 ± 26） μg/L, （ 15 ± 5 ） mm/h, （85 ±7） fl, （30±3） pg and （335±25） g/L, respectively. Compared with the control group, the patients in SCLC group were significantly increased on the levels of SF （ t = 14. 168, P 〈 0. 001 ） and MCV （ t = 6. 143, P 〈 0. 001 ） , and were significantly decreased on the level of MCHC （t = - 4. 220, P = 0. 003 ）. There were no significant difference in the levels of ESR （t = 1. 931, P =0. 102） and MCH （t = 1. 220, P = 0. 313 ） between the two groups. The serum levels of SF and MCV were significantly correlated with the stage of SCLC （ t = - 4. 092, P = 0. 009 ; t = - 4. 985, P 〈 0. 001 ）. Multivariate logistic regression analysis showed that high serum SF （OR = 5.31, 95% CI： 3.09-9.31, P 〈 0. 001 ） and MCV （ OR = 1.78, 95% CI： 1. 10- 3.08, P = 0. 013） were independent risk factors of SCLC. Survival analysis showed that the survival time of the patients in the high SF group was significantly shorter than that in the low SF group （6 months vs. 20 months; χ^2 = 6. 556, P = 0. 001 ）. Conclusion Serum ESR, MCH and MCHC levels are not significantly correlated with SCLC, but serum SF and MCV levels are of important clinical significance in evaluating the prognosis of SCLC patients.