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目的探讨鼻咽癌患者中性粒细胞(NEUT)、淋巴细胞计数(LY)与鼻咽癌放射性口腔黏膜炎程度和肿瘤消退率之间的关系以及放疗前后的动态变化规律。方法选择首诊鼻咽癌患者68例为实验对象(观察组),采集入院时、放疗后第2、3、4、5、6、7周以及放疗结束、放疗后3个月患者血清标本,采用全自动血细胞分析仪分别检测患者外周血白细胞(WBC)、NEUT和中性粒细胞比例(NEUTR)、LY和淋巴细胞比例(LYR)、中性粒细胞和淋巴细胞比例(NLR);另同期选择40名健康者作对照(对照组)。结果鼻咽癌患者WBC、NEUT、NEUTR、LY、LYR及NLR与对照组比较差异无统计学意义(P均>0.05);治疗后NEUTR和NLR明显高于治疗前(P均<0.01);治疗后WBC、LY、LYR明显下降(P均<0.01)。放疗后第3、4、5、6、7周、放疗结束时及放疗后3个月患者的NEUTR均与同期口腔黏膜炎分级有关(P均<0.05)。治疗前后LYR变化与放疗结束时肿瘤消退率有关(P=0.048)。治疗期间口腔黏膜损伤程度与治疗结束时疗效有关(P=0.012)。结论治疗期间监测中性粒细胞比例有助于判断放射性口腔黏膜损伤程度。治疗期间定期评价放射性口腔黏膜损伤程度,有助于预测肿瘤的近期疗效。
Objective To investigate the relationship between neutrophil (NEUT), lymphocyte count (LY) and the degree of radiation-induced oral mucositis in nasopharyngeal carcinoma (NPC) and the rate of tumor regression and the dynamic changes before and after radiotherapy. Methods Sixty-eight patients with nasopharyngeal carcinoma were selected as the experimental group (observation group). At admission, 2, 3, 4, 5, 6 and 7 weeks after radiotherapy and the end of radiotherapy, serum samples, The WBC, NEUT and NEUTR, LY and lymphocyte ratio (LYR), neutrophil and lymphocyte proportion (NLR) were detected by automatic hematology analyzer. Forty healthy individuals were selected as control group (control group). Results There was no significant difference in WBC, NEUT, NEUTR, LY, LYR and NLR between NPC and control group (all P> 0.05), and the levels of NEUTR and NLR after treatment were significantly higher than those before treatment (all P <0.01) After WBC, LY, LYR decreased significantly (all P <0.01). NEUTR at the end of 3, 4, 5, 6, 7 weeks after radiotherapy and at the end of radiotherapy and 3 months after radiotherapy were all related to the classification of oral mucositis in the same period (all P <0.05). The change of LYR before and after treatment was related to the tumor regression rate at the end of radiotherapy (P = 0.048). The degree of oral mucosal injury during treatment was related to efficacy at the end of treatment (P = 0.012). Conclusion Monitoring the proportion of neutrophils during treatment can help determine the degree of radioactive oral mucosal injury. Periodic evaluation of radioactive oral mucosal injury during treatment will help predict the near-term efficacy of the tumor.