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目的:探讨白细胞数量稳定性对晚期非小细胞肺癌(NSCLC)患者化疗预后的影响。方法:采用前瞻性研究方法,根据化疗后白细胞计数较化疗前是否下降及下降程度,将患者分为下降且出现白细胞减少(CIL,白细胞<4.0×109 L-1)组、下降但未出现CIL组及未下降组,通过随访及统计学软件分析各组化疗有效率(RR)、疾病控制率(DCR),疾病进展时间(TTP)、总生存时间(OS)之间的差异,并确定影响预后的独立因素。结果:共入组87例患者,3组RR分别为36.3%、27.9%和13.6%(χ2=3.016,P=0.221);DCR分别为90.9%、81.4%和68.2%(χ2=3.706,P=0.157),中位TTP分别是8、7和5个月(χ2=6.119,P=0.047),中位OS分别是20、14和12个月,χ2=6.716,P=0.035。Cox多因素分析显示,CIL是影响晚期NSCLC患者生存时间的独立因素,χ2=17.589,P=0.000。结论CIL能够延长患者的疾病进展时间和生存时间,是影响晚期NSCLC患者化疗的预后的独立影响因素。
Objective: To investigate the effect of white blood cell number stability on the prognosis of patients with advanced non-small cell lung cancer (NSCLC). Methods: A prospective study was conducted to determine if the number of leukopenia (CIL, <4.0 × 109 L-1 leukemia cells) was decreased and no CIL was observed according to whether the leukocyte count decreased or decreased after chemotherapy compared with that before chemotherapy (RR), disease control rate (DCR), disease progression time (TTP) and total survival time (OS) in each group were analyzed by follow-up and statistical software, and the influence was determined Independent prognostic factor. Results: The RR of the three groups were 36.3%, 27.9% and 13.6%, respectively (χ2 = 3.016, P = 0.221). The DCR were 90.9%, 81.4% and 68.2% 0.157). The median TTP was 8, 7 and 5 months respectively (χ2 = 6.119, P = 0.047). The median OS was 20, 14 and 12 months, respectively, χ2 = 6.716 and P = 0.035. Cox multivariate analysis showed that CIL was an independent factor affecting the survival time of patients with advanced NSCLC, χ2 = 17.589, P = 0.000. Conclusion CIL can prolong the patient’s disease progression time and survival time, which is an independent factor affecting the prognosis of patients with advanced NSCLC.