CAJ | 학술논문

Objective: The purpose of this study was to determine whether the decrease of WBC is correlated with the increase of apoptosis induced by cytotoxic drugs in patients who received neoadjuvant polychemotherapy for ovarian cancer and whether the reduction of peripheral blood WBC can be predicted by the detection of apoptosis. Methods: The study included 25 patients who received neoadjuvant polychemotherapy for ovarian cancer after operation. Total 2 ml of venous blood was collected from these subjects within 24 hours before chemotherapy and at the fifth day after the beginning of chemotherapy. Peripheral blood WBC count was performed and its apoptosis was analyzed using flow cytometry (FCM) and DNA electrophoresis. Results: 68% (17/25) of the patients had a decrease in WBC after chemotherapy. The average counts of WBC were 5.19±1.36×109/L and 4.36±1.56×109/L, the distributions were 4.10～8.60×109/L and 2.00～7.90×109/L before and after chemotherapy respectively. At the same time, 64%(16/25) of the patients had an increase in apoptotic cells. The proportions of apoptosis were 4.01±2.59% and 5.66±1.36%, the distributions were 1.05～11.02% and 0.8～14.08% before and after chemotherapy respectively. Both the decrease of WBC and the increase of apoptosis were statistical significant (P<0.05). The coefficient between the decrease of WBC and the increase of apoptosis is 0.646(P<0.05). The sensitivity of the quantitative analysis of apoptosis using FCM for clinical early diagnosis of the decrease of WBC is 82%, the speciality is 75% and the accuracy is 80%. Conclusion: The increased apoptosis induced by cytotoxic drugs contributed to the chemotherapy-associated reduction of WBC at some extend, there were somewhat correlation between them. The detection of peripheral apoptosis could be of some help to assess the decrease and scientific bases for the administration of G-CSF, GM-CSF to obtain the optimal cost-effectiveness of clinical chemotherapy.