CAJ | 학술논문

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。
목적：탐토비인암환자중성립세포（NEUT）、림파세포계수（LY）여비인암방사성구강점막염정도화종류소퇴솔지간적관계이급방료전후적동태변화규률。방법선택수진비인암환자68례위실험대상（관찰조），채집입원시、방료후제2、3、4、5、6、7주이급방료결속、방료후3개월환자혈청표본，채용전자동혈세포분석의분별검측환자외주혈백세포（ WBC ）、NEUT화중성립세포비례（ NEUTR ）、LY화림파세포비례（ LYR）、중성립세포화림파세포비례（ NLR）；령동기선택40명건강자작대조（대조조）。결과비인암환자WBC、NEUT、NEUTR、LY、LYR급NLR여대조조비교차이무통계학의의（ P균＞0.05）；치료후NEUTR화NLR 명현고우치료전（ P균＜0.01）；치료후WBC、LY、LYR명현하강（ P균＜0.01）。방료후제3、4、5、6、7주、방료결속시급방료후3개월환자적NEUTR균여동기구강점막염분급유관（ P균＜0.05）。치료전후LYR변화여방료결속시종류소퇴솔유관（ P＝0.048）。치료기간구강점막손상정도여치료결속시료효유관（ P＝0.012）。결론치료기간감측중성립세포비례유조우판단방사성구강점막손상정도。치료기간정기평개방사성구강점막손상정도，유조우예측종류적근기료효。
Objective To investigate the relationship among neutrophils (NEUT), lymphocyte count(LY), radiation-induced oral mucositis and tumor regression rate in patients with nasopharyngeal carcinoma , as well as the dynamic changes before and after treatment .Methods Sixty-eight patients with nasopharyngeal carcinoma first diag-nosed as experimental group , serum samples were collected at admission , two weeks, three weeks, four weeks, five weeks, six weeks, seven weeks after radiotherapy , the end of radiotherapy , 3 months after radiotherapy .Automatic blood cell analyzer was used to detect leukocytes (WBC), NEUT and neutrophil proportion (NEUTR), LY and lym-phocyte proportion ( LYR) , proportion of neutrophils and lymphocytes ( NLR) , and 40 healthy people were enrolled in control group.Results WBC, NEUT, NEUTR, LY, LYR and NLR did not show significant difference between NPC patients and healthy people ( all P>0.05 ) .NEUTR and NLR after treatment were significantly higher than before treatment(all P<0.01);WBC, LY, LYR after treatment were decreased significantly (all P<0.01).NEUTR was correlated with the degree of oral mucositis during the same period at 3,4,5,6,7 weeks, the end of radiotherapy and 3 months after radiotherapy ( all P<0.05 ) .The changes in LYR was correlated with tumor regression rate ( P=0.048 ) .The degree of oral mucosal injury was correlated with tumor regression rate at the end of radiotherapy ( P=0.012 ) .Conclusion Monitoring the proportion of neutrophils can help judge the degree of radiation -induced oral mucosal injury during treatment .Periodic evaluation of radiation-induced oral mucosal injury during the treatment could help to predict short-term effect of NPC .