预后营养指数与结直肠癌患者化疗后粒细胞减少的关系

Relationship between prognostic nutritional index and neutropenia after chemotherapy in patients with colorectal cancer

目的探讨预后营养指数(PNI)与结直肠癌患者辅助化疗后粒细胞减少的关系。方法回顾性分析2014年12月至2018年1月就诊于北京市顺义区医院的44例结直肠癌辅助化疗患者的临床资料,按粒细胞减少程度分为A组(0~2级粒细胞减少)和B组(3~4级粒细胞减少)。收集患者化疗前1周内血清清蛋白、外周淋巴细胞计数、中性粒细胞计数,并计算PNI。采用χ2检验和秩和检验比较两组患者的临床资料、体质量指数(BMI)、基线中性粒细胞计数及PNI,采用logistic回归分析化疗后粒细胞减少的危险因素。结果 A组基线中位中性粒细胞计数和中位PNI分别为3.17×109/L[(1.38~7.79)×109/L]和50.40(37.40~57.05),高于B组的2.54×109/L[(1.22~3.87)×109/L]和45.50(37.95~50.95),两组间差异均有统计学意义(Z=-2.085,P=0.037;Z=-2.615,P=0.009)。logistic回归分析提示PNI为影响化疗后粒细胞减少的独立危险因素(HR=0.803,95% CI 0.646~0.998,P=0.048)。结论 PNI对预测结直肠癌患者辅助化疗后粒细胞减少有一定提示作用。

Objective To investigate the relationship between prognostic nutritional index (PNI) and neutropenia after adjuvant chemotherapy in patients with colorectal cancer. Methods The clinical data of 44 patients with colorectal cancer performed adjuvant chemotherapy in Shunyi District Hospital from December 2014 to January 2018 were retrospectively analyzed, and the patients were divided into group A (grade 0-2 neutropenia) and group B (grade3-4 neutropenia) according to the degree of neutropenia. The serum albumin, peripheral lymphocyte counts, and neutrophil counts within 1 week before chemotherapy were collected, and the PNI was calculated. The chi-square test and rank sum test were used to compare the clinical data, body mass index (BMI), baseline neutrophil count, and PNI between the two groups. Logistic regression analysis was used to analyze the risk factors for neutropenia after chemotherapy. Results The baseline median neutrophil counts and median PNI in group A were 3.17×109/L [(1.38-7.79)×109/L] and 50.40 (37.40-57.05), and in group B were 2.54×109/L [(1.22-3.87)×109/L] and 45.50 (37.95-50.95). The baseline neutrophil counts and PNI in group A were significantly higher than those in group B, the differences between the two groups were statistically significant (Z=-2.085, P=0.037;Z=-2.615, P=0.009). Logistic regression analysis showed that PNI was an independent risk factor for neutropenia after chemotherapy (HR=0.803, 95%CI 0.646-0.998, P=0.048). Conclusion PNI has a certain role in predicting neutropenia after adjuvant chemotherapy in patients with colorectal cancer.