目的 探讨晚期胃癌患者一线化疗前后血红蛋白水平变化与预后及化疗疗效的关系.方法 收集84例晚期胃癌患者的临床资料,应用SPSS 20.0软件对一线化疗前后血红蛋白变化与晚期胃癌患者的化疗疗效及生存的关系进行分析.结果 疾病进展患者化疗前后血红蛋白均值分别为(120.17±22.54)和(97.17±21.67)g/L(P =0.017),有内脏转移的患者化疗前后血红蛋白均值分别为(115.66±19.05)和(109.11±17.73)g/L(P =0.012),有肝脏转移的患者化疗前后血红蛋白均值分别为(116.40±17.57)和(110.13± 17.64)g/L(P =0.015).未见血红蛋白变化与患者年龄、ECOG评分、病理分型、病灶位置和有无腹膜转移等因素相关.生存分析显示化疗前贫血的胃癌患者预后较差,但差异无统计学意义(P=0.119).结论 晚期胃癌患者血红蛋白降低与化疗疗效有关,化疗后血红蛋白降低提示较差的疗效.化疗前无贫血的胃癌患者显示出较好的预后.%Objective To investigate the correlation between the first line chemotherapy-induced hemogulobin changes and prognosis or chemotherapeutic response in advanced gastric cancer patients. Methods The clinical characters of 84 advanced gastric cancer patients were collected, and SPSS 20.0 software was used for (he analysis of the correlation between the first line chemotherapy-induced hemogulobin changes and chemotherapeutic response or survival. Results Mean hemoglobin values before and after chemotherapy were (120.17±22.54)g/ L and (97.17±21.67)g/L respectively in progressive patients, (115.66±19.05)g/L and (109.11 ±17.73)g/L in patients with viscera metastasis (P =0.012), (116.40±17.57)g/L and (110.13±17.64)g/L respectively in patients with liver metastasis (P=0.015). The relationship between hemoglobin and age,ECOG,pathologic types,tumor location or peritoneal dissemination was not observed. Survival analysis shows patients with pre-chemotherapy anemia had a bad prognosis, but was not statistical significant (P =0.119). Conclusion The changes of hemoglobin in patients treated for advanced gastric cancer are related to chemotherapy response,and chemotherapy-induced decrease of hemoglobin indicates a worse response. Meanwhile, pre-chemotherapy anemia indicates worse prognosis.
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