内源性粒细胞集落刺激因子对非小细胞肺癌化疗后白细胞的影响

摘要

Objective To investigate the relationships between endogenous granulocyte colony-stimulating factor (G-CSF) and white blood cell (WBC) of non-small cell lung cancer (NSCLC).Methods Ninety-four patients with NSCLC were involved in the study.Of these patients,71 were treated with chemotherapy (experiment group) and 23 treated with surgery (control group).Blood samples of the two groups were collected before and on the 6th day after chemotherapy.Results ①In the experiment group,the WBC counts and serum levels of G-CSF after chemotherapy were significantly lower than that before chemotherapy (P ＜ 0.05).②The basal levels of G-CSF in patients with decreased WBC count was significantly lower than that in patients with normal WBC count or increased WBC count or in the control group (P ＜ 0.05).③In the experiment group,there were 30 cases with lower WBC count after chemotherapy.In these patients the levels of serum G-CSF were 0.0349 ±0.0279 ng/ml after chemotherapy,significantly lower than that (0.089±0.049 ng/ml) before the therapy (P ＜ 0.05).④There was a significant correlation between WBC counts and endogenous serum GCSF levels(r =0.265,P ＜ 0.05).Conclusion The reduction of WBC count after chemotherapy is associated with the basal levels of G-CSF in patients with NSCLC.The endogenous G-CSF level is positively correlated with WBC count in NSCLC patients.%目的 探讨非小细胞肺癌(non small cell lung cancer,NSCLC)患者化疗前后白细胞的变化与患者内源性粒细胞集落刺激因子(granulocyte colony stimulating factor,G-CSF)的关系.方法 共入选NSCLC患者94例,其中71例接受化疗(试验组),23例因为经济原因拒绝化疗或者行手术治疗者(对照组),试验组分别在化疗前第一天与化疗后第六天采血,对照组采血的时间与试验组同步,检测化疗后白细胞计数及G-CSF水平.结果 ①71例接受化疗的患者化疗后白细胞计数低于化疗前,G-CSF值较化疗前下降,差异有统计学意义(P＜0.05).②进一步分析显示,化疗后白细胞下降组患者G-CSF基础水平明显低于白细胞正常组、白细胞升高组和对照组的G-CSF水平,差异有统计学意义(P＜0.05).③接受化疗的71例患者中,白细胞下降者30例,该组化疗后的血清G-CSF水平[(0.034±0.0279) ng/ml]明显低于化疗前[(0.889±0.049) ng/ml],差异有统计学意义(P＜0.05).④相关分析研究结果显示,化疗后白细胞计数与内源性G-CSF表达水平的相关系数r为0.265,差异有统计学意义(P＜0.05).结论 NSCLC患者化疗所致的外周血白细胞下降与患者内源性G-CSF的基础水平有关,而且呈正相关.