| Objective:Recently,The incidence and mortality of world’s lung cancer showed an upward trend,The World Health Organization International Agency for Research on Cancer(IARC) 2013 released in GLOBOCAN2012 cancer report:New cases of global lung cancer in 2012 forecast of about 1.8 million cases,the mortality is about 1.6 million,accounting for new cases and deaths of cancer by 13% and 19.4% respectively,ranking first of malignancy. Currently implementation of comprehensive treatment in lung cancer make mortality of lung cancer decreased,but Some patients result in poor tolerance of chemotherapy,reduced quality of life and so on.eventually leading to disease progression,even life-threatening because of side effects caused by treatment. The subject application retrospective study of before and after chemotherapy were each index entry and statistical analysis of blood,The subject enter and statistical analysis blood index before and after chemotherapy of patients in lung cancer,applying retrospective study methods,in order to find an index to predict tolerance of chemotherapy,provide a theoretical basis about the choice of chemotherapy drugs and the number of cycles.Methods: 1 Collect medical records of lung cancer patients on department of Medical Oncology admitted to the Fourth Hospital of Hebei Medical University, during January 2012 to July 2014,a total of 311 cases,including 186 cases of small cell carcinoma,squamous cell carcinoma and 46 cases,79 cases of adenocarcinoma.The total number of chemotherapy cycles is 1518 cycles, including small cell carcinoma of 1060 cycles,195 cycles of squamous cell carcinoma,adenocarcinoma 261 cycles.The average number of cycles each cycle is 4.88. 2 Specimen collection : Morning fasting elbow peripheral blood of lung cancer.3 Collateing and entrying clinical data,establishing a database and grouping analysis of the data. 3.1 In accordance with the pathological type:Group A:squamous cell carcinoma;Group B:adenocarcinoma;Group C:Small cell carcinoma 3.2 Grouped according to the chemotherapy cycle:Group A:before period;Group B: after four cycles 3.3 According to the stage grouping:Group A:I-II period;Group B:III-IV period 3.4 Grouped by gender:Group A gender is male;Group B gender is female 3.5 According to age groups:Group A:less than or equal to 50 years of age;Group B: more than 50 years old 4 Input indicators:the percentage of neutrophils,neutrophil count, hemoglobin, red blood cell count,hematocrit,mean corpuscular volume,mean corpuscular hemoglobin,hemoglobin concentration,red blood cell distribution width and so on. 5 Using SPSS 20.0 statistical software for data analysis. For all variables to adopt frequency,frequency and other descriptive analysis.Inter-group analysis of count data using X2 test(chi-square test).Using binary Logistic regression analysis to explore relations between blood granulocyte erythroid abnormalities and anemia,chemotherapy tolerance after the intervention of chemotherapy in lung cancer patients.Results:We eventually chose 311 qualified cases and 1518 qualified Hematology cycles,the results were as follows: 1 Clinical data analysis 1.1 General data analysis:Males have 222 cases,71.38% of the total number. Women have 89 cases,28.62% of the total number;age before 50 years old have 62 cases,accounting for 20 % of the total,age after 50 years had 249 cases,accounting for 80 % of the total,with a median age of 60 years old( 28 years old-84 years old). 1.2 Disease data Analysis:pathological types:inluding 46 cases of squamous cell carcinoma,79 cases of adenocarcinoma,186 cases of small cell carcinoma, accounting for 14.79%,25.40%,59.81% of the total respectively;pathological stage:123 cases of stage I-II,39.55% of the total number,of which 12 cases of squamous cell carcinoma,11 cases of adenocarcinoma,and 100 cases of small cell carcinoma,accounting for 9.76%,8.94%,81.30% of the total respectively; the 188 cases of III-IV stage,accounting for 60.45% of the total,which scales 34 cases of carcinoma,adenocarcinoma,68 cases,86 cases of small cell carcinoma,accounting for 18.09%,36.17%,45.74% of the total,respectively. 1.3 Treatment data analysis:There are 135 cases before 4 chemotherapy cycles,accounting for 43.41% of the total,176 cases of after 4 chemotherapy cycles,accounting 56.59% of the total. 2 Univariate analysis of related factors about each index expression after chemotherapy 2.1 The index expression after chemotherapyin lung cancer(positive period / total number of cycles):the percentage of neutrophils neutral was 233 cycles,the neutrophil count was 205 cycles,red blood cell was 403 cycles, hemoglobin 412 cycles,hematocrit for 625 cycles,mean corpuscular volume of 21 cycles,mean corpuscular hemoglobin of 21 cycles,corpuscular hemoglobin concentration for 91 cycles,red blood cell distribution width for two cycles,the percentage is 15.35%,13.50%,26.55%,27.14%,41.17%,1.38%,1.38%, 5.99%, 0.13% respectively. Hematocrit is most frequently appear in expression after chemotherapy. 2.2 Anemia Occurrence: The staging by NCI,the total number of cycles of anemia after chemotherapy cycle for 1269,accounting for 83.60% of the total number, non- anemic for 249 cycles,accounting for 16.40%,including mild anemia of 1100( 86.68 %),moderate anemia 155( 12.21%),and severe anemia was 12( 0.95%),very severe anemia 2( 0.16%).For statistical analysis,red blood cell count,hemoglobin,hematocrit,and mean corpuscular volume expression between different degrees of anemia is different,there are statistically significant.(X2=293.176 P=0.000<0.05,X2=384.527 P =0.000<0.05,X2=187.102 P =0.000<0.05,X2=8.987 P =0.029<0.05).The staging by Hematocrit,the total number of cycles of anemia after chemotherapy cycle for 1475,accounting for 97.17% of the total number, non- anemic for 33 cycles,accounting for 2.83%,including mild anemia of 778( 52.75 %),moderate anemia 683( 46.31%),and severe anemia was 24( 1.63%),For statistical analysis,neutrophil count,red blood cell count, hemoglobin,hematocrit,mean corpuscular volume and mean corpuscular hemoglobin expression differs between different levels of anemia,there are significant differences(X2=23.846 P =0.000<0.05,X2=600.966 P=0.000<0.05, X2=659.095 P=0.000<0.05,X2=1193.612 P=0.000<0.05,X2=10.741 P =0.013 <0.05, X2=8.262 P =0.041<0.05).Therefore,the degree of anemia after chemotherapy intervention is more common in mild to moderate, but more performance in red blood cell count,hemoglobin,hematocrit,mean corpuscular volume and mean corpuscular hemoglobin decrease. 2.3Related factors of chemotherapy tolerability:Expression after chemoth- erapy prone to have hematocrit 41.17%,hemoglobin 27.14%,red blood cell count 26.55%,neutrophil percentage of 15.35%.And neutrophil count expression in various pathological types is different,there are statistically significant(X2=17.774 P=0.000<0.05),and hemoglobin abnormalities differ between squamous cell carcinoma,adenocarcinoma,there are statistically significant.(X2= 6.357 P = 0.012 <0.05). Neutrophil count and red blood cell count expression differs between men and women of different genders,there are statistically significant.(X2 = 4.326 P = 0.038 <0.05, X2= 3.970 P = 0.046 <0.05).Red blood cell count between expression in stage I-II and III-IV installments is different,there are statistically significant.(X2 = 7.210 P=0.007<0.05). Mean corpuscular volume,mean corpuscular hemoglobin,red blood cell hemoglobin concentration expression between < 4 and ≥4 different cycles of chemotherapy group,a significant difference.(X2 = 10.203 P = 0.001 <0.05,X2= 10.203 P = 0.001 <0.05,X2 = 6.751 P =0.009 <0.05). Therefore,as a chemotherapy tolerability assessment indicators. 3 Relationship among multivariate and between tolerance and chemotherapy: There is correlation between hemoglobin,hematocrit,and the correlation coefficient was 0.060,P =0.019,statistically significant. Red blood cell count and hemoglobin,hematocrit between hemoglobin,the correlation coefficient was 0.682,0.278,P =0.000,0.000,there are statistically significant. Between hemoglobin hematocrit and hemoglobin,the correlation coefficient was 0.370, P =0.000,statistically significant. Chemotherapy was well tolerated and red blood cell count,hemoglobin-related correlation coefficient of 0.153,0.116,P = 0.000,0.000,there are statistically significant.Conclusions:1 After chemotherapy in patients with lung cancer drug intervention erythroid hematocrit,hemoglobin,red blood cell count,neutrophil percentage proneto abnormalities.2 Univariate analysis showed that:After histological type,tumor stage,sex and intervention cycles of chemotherapy with chemotherapy or peripheral blood granulocyte erythroid abnormalities occur there is a close relationship,but after the age of chemotherapy-related interventions in peripheral blood granulocyte erythroid unrelated exception occurs.3 Anemia analysis shows: the degree of anemia after chemotherapy intervention is more common in mild to moderate,but more performance in red blood cell count,hemoglobin,hematocrit,and mean corpuscular volume decline.4 Correlation analysis showed that:the percentage of neutrophils,red blood cell count,the presence of hemoglobin and hematocrit between correlation and chemotherapy tolerance and red blood cell count,hemoglobin correlation. |
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