[1]吴 霞,刘祥燕,雍小梅,等.放化疗前血红蛋白/血小板比值、C-反应蛋白/白蛋白比值与局部晚期鼻咽癌患者同步放化疗发生放射性骨坏死关系研究[J].陕西医学杂志,2024,(5):632-636.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.012]
　WU Xia,LIU Xiangyan,YONG Xiaomei,et al.Relationship between hemoglobin-to-platelet ratio,C-reactive protein to albumin ratio before chemoradiation and osteoradionecrosis in patients with locoregionally advanced nasopharyngeal carcinoma after concurrent chemoradiotherapy[J].,2024,(5):632-636.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.012]
点击复制

放化疗前血红蛋白/血小板比值、C-反应蛋白/白蛋白比值与局部晚期鼻咽癌患者同步放化疗发生放射性骨坏死关系研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年5期
页码:
632-636
栏目:
临床研究
出版日期:
2024-05-05

文章信息/Info

Title:
Relationship between hemoglobin-to-platelet ratio,C-reactive protein to albumin ratio before chemoradiation and osteoradionecrosis in patients with locoregionally advanced nasopharyngeal carcinoma after concurrent chemoradiotherapy
作者:
吴 霞; 刘祥燕; 雍小梅; 晏晴艳; 蒋朝阳
(解放军西部战区总医院肿瘤科,四川 成都 610083)
Author(s):
WU Xia; LIU Xiangyan; YONG Xiaomei; YAN Qingyan; JIANG Chaoyang
(Department of Oncology,Western Theater Command General Hospital of PLA,Chengdu 610083,China)
关键词:
局部晚期鼻咽癌;  同步放化疗;  放射性骨坏死;  血红蛋白/血小板比值;  C-反应蛋白/白蛋白比值;  预测价值
Keywords:
Locoregionally advanced nasopharyngeal carcinoma;  Concurrent chemoradiotherapy;  Osteoradionecrosis;  Hemoglobin-to-platelet ratio;  C-reactive protein to albumin ratio;  Predictive value
分类号:
R 739.6
DOI:
DOI:10.3969/j.issn.1000-7377.2024.05.012
文献标志码:
A
摘要:
目的:探讨放化疗前血红蛋白/血小板比值(HPR)、C-反应蛋白/白蛋白比值(CAR)与局部晚期鼻咽癌(LA-NPC)患者同步放化疗(CCRT)发生放射性骨坏死(ORN)的关系。方法:选取接受CCRT治疗的LA-NPC患者457例,CCRT前检测并计算HPR和CAR,CCRT后定期随访,统计ORN发生情况。根据是否发生ORN将患者分为ORN组(33例)和无ORN组(418例)。多因素Logistic回归分析LA-NPC患者CCRT后发生ORN的影响因素。绘制受试者工作特征(ROC)曲线分析HPR和CAR对LA-NPC患者CCRT后发生ORN的预测价值。结果:457例患者失访6例,451例患者中33例发生ORN,ORN发生率为7.32%。ORN组TNM分期为ⅣA期、颅底侵犯、CCRT前或后拔牙、既往有牙科疾病、口腔卫生状况不佳比例高于无ORN组(均P<0.05)。ORN组HPR低于无ORN组,CAR高于无ORN组(均P<0.05)。CCRT前或后拔牙、口腔卫生状况、CAR及HPR是LA-NPC患者CCRT后发生ORN的独立影响因素(均P<0.05)。HPR和CAR两者联合预测LA-NPC患者CCRT后发生ORN的AUC高于两者单独预测AUC(均P<0.05)。结论:CCRT后发生ORN的LA-NPC患者CCRT前HPR降低,CAR增高,两者与LA-NPC患者CCRT后发生ORN有关,对CCRT后ORN发生具有一定预测价值。
Abstract:
Objective:To investigate the relationship between hemoglobin-to-platelet ratio(HPR),C-reactive protein to albumin ratio(CAR)before chemoradiation and osteoradionecrosis(ORN)in patients with locoregionally advanced nasopharyngeal carcinoma(LA-NPC)after concurrent chemoradiotherapy(CCRT).Methods: A total of 457 LA-NPC patients receiving CCRT were selected.HPR and CAR were detected and calculated before CCRT,and the incidence of ORN was analyzed by regular follow-up after CCRT.Patients were divided into ORN group(33 cases)and non-ORN group(418 cases)according to whether ORN occurred.Multivariate Logistic regression was used to analyze the influencing factors of ORN after CCRT in LA-NPC patients.Receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of HPR and CAR in the development of ORN after CCRT in LA-NPC patients.Results: Of the 457 patients,6 were lost to follow-up,and 33 of the 451 patients developed ORN,with an incidence of 7.32%.The proportion of TNM stage ⅣA,skull base invasion,tooth extraction before or after CCRT,previous dental disease and poor oral health in ORN group was higher than that in non-ORN group(all P<0.05).HPR in ORN group was lower than that in non-ORN group,and CAR in ORN group was higher than that in non-ORN group(all P<0.05).Tooth extraction before or after CCRT,oral hygiene,CAR and HPR were independent factors for the occurrence of ORN after CCRT in LA-NPC patients(all P<0.05).The AUC predicted by HPR and CAR in LA-NPC patients with ORN after CCRT was higher than that predicted by HPR and CAR alone(all P<0.05).Conclusion:Low HPR and high CAR before CCRT are associated with the development of ORN after CCRT in LA-NPC patients,and both of them have a certain predictive value for the occurrence of ORN after CCRT.

参考文献/References:

[1] ZHONG L,DONG D,FANG X,et al.A deep learning-based radiomic nomogram for prognosis and treatment decision in advanced nasopharyngeal carcinoma:A multicentre study[J].EBio Medicine,2021,70:103522.
[2] 苏建淳,张国义,卢秋霞,等.miR-124在鼻咽癌组织中的表达及其与预后关系研究[J].陕西医学杂志,2020,49(2):144-147.
[3] 张璇,朱海龙,哈敏文.TGFβ-SMAD通路基因多态性与鼻咽癌预后相关性研究[J].陕西医学杂志,2019,48(11):1430-1434.
[4] 马国辉,董艳玲,吴楠,等.养阴解毒汤对气阴两虚型晚期鼻咽癌放化疗患者免疫功能和癌因性疲乏的影响[J].陕西中医,2022,43(10):1407-1410.
[5] GREENHILL M J,JEAN S P,DUHANCIOGLU G,et al.Osteoradionecrosis of the skull base in nasopharyngeal carcinoma[J].Radiol Imaging Cancer,2023,5(1):e220159.
[6] MO C J,HU Z J,QIN S Z,et al.Diagnostic value of platelet-lymphocyte ratio and hemoglobin-platelet ratio in patients with rectal cancer[J].J Clin Lab Anal,2020,34(4):23153.
[7] LIAO C K,YU Y L,LIN Y C,et al.Prognostic value of the C-reactive protein to albumin ratio in colorectal cancer:An updated systematic review and meta-analysis[J].World J Surg Oncol,2021,19(1):139.
[8] ZHU M,MA Z,ZHANG X,et al.C-reactive protein and cancer risk:A pan-cancer study of prospective cohort and Mendelian randomization analysis[J].BMC Med,2022,20(1):301.
[9] 中国医师协会放射肿瘤治疗医师分会,中华医学会放射肿瘤治疗学分会,中国抗癌协会肿瘤放射治疗专业委员会,等.中国头颈部肿瘤放射治疗指南(2021年版)[J].国际肿瘤学杂志,2022,49(2):65-72.
[10] ZHONG X,LI L,JIANG H,et al.Cervical spine osteoradionecrosis or bone metastasis after radiotherapy for nasopharyngeal carcinoma? The MRI-based radiomics for characterization[J].BMC Med Imaging,2020,20(1):104.
[11] 赵燕.人参皂苷Rg3对鼻咽癌Th1/Th2细胞因子表达情况及临床治疗效果分析[J].陕西中医,2018,39(1):101-103.
[12] 黄金圣,黄学武.养阴清热法对鼻咽癌放疗后患者敏感性的影响[J].陕西中医,2015,36(9):1195-1197.
[13] 房丽,王玲玲,王红阳,等.百合固金汤联合同步放化疗治疗局部晚期非小细胞肺癌疗效观察[J].陕西中医,2014,35(4):467-469.
[14] MOON D H,MOON S H,WANG K,et al.Incidence of,and risk factors for,mandibular osteoradionecrosis in patients with oral cavity and oropharynx cancers[J].Oral Oncol,2017,72:98-103.
[15] CAPARROTTI F,HUANG S H,LU L,et al.Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy[J].Cancer,2017,123(19):3691-3700.
[16] IRAWAN C,RACHMAN A,RAHMAN P,et al.Role of pretreatment hemoglobin-to-platelet ratio in predicting survival outcome of locally advanced nasopharyngeal carcinoma patients[J].J Cancer Epidemiol,2021,2021:1103631.
[17] SOMAY E,YILMAZ B,TOPKAN E,et al.Hemoglobin-to-platelet ratio in predicting the incidence of trismus after concurrent chemoradiotherapy[J].Oral Dis,2023,29(7):2962-2970.
[18] DHANDA J,PASQUIER D,NEWMAN L,et al.Current concepts in osteoradionecrosis after head and neck radiotherapy[J].Clin Oncol(R Coll Radiol),2016,28(7):459-466.
[19] CASTILLO-RODRIGUEZ R A,TREJO-SOLIS C,CABRERA-CANO A,et al.Hypoxia as a modulator of inflammation and immune response in cancer[J].Cancers(Basel),2022,14(9):2291.
[20] 李晓丹,杜江蓉.肿瘤合并感染患者与非肿瘤感染患者血清降钙素原与C反应蛋白变化分析[J].陕西医学杂志,2018,47(12):1612-1614.
[21] TAMAI K,OKAMURA S,MAKINO S,et al.C-reactive protein/albumin ratio predicts survival after curative surgery in elderly patients with colorectal cancer[J].Updates Surg,2022,74(1):153-162.
[22] DENG T B,ZHANG J,ZHOU Y Z,et al.The prognostic value of C-reactive protein to albumin ratio in patients with lung cancer[J].Medicine(Baltimore),2018,97(50):13505.
[23] YILMAZ B,SOMAY E,TOPKAN E,et al.Utility of pre-chemoradiotherapy pan-immune-inflammation-value for predicting the osteoradionecrosis rates in locally advanced nasopharyngeal cancers[J].Strahlenther Onkol,2023,199(10):910-921.
[24] 王颖.炎症微环境通过肿瘤坏死因子α诱导蛋白-6抑制牙髓干细胞的BMP-4/Smad信号通路及其成牙/成骨分化的作用研究[D].郑州:郑州大学,2020.
[25] HUANG Q,HE X,YANG W F,et al.Nutritional status in patients of mandibular osteoradionecrosis:A single-institution experience[J].Oral Dis,2022,28(2):513-520.

备注/Memo

备注/Memo:
基金项目:四川省卫生健康委员会医学科技项目(21PJ068)
更新日期/Last Update: 2024-05-06