食管癌患者放射治疗中照射体积和时间与外周血淋巴细胞绝对值的相关性研究

摘要 目的：探究照射体积和时间与食管癌患者外周血淋巴细胞绝对值的相关性。方法：本研究方案将纳入2019年1月~2019年12月蚌埠医学院第一附属医院放疗科收治的放疗或同步放化疗食管癌患者84例，其中单独放疗患者24例，同步放化疗患者60例，采用血液细胞分析仪测定患者放疗期间每周复查外周血白细胞（WBC）、中性粒细胞（N）、淋巴细胞（L）、血红蛋白（HB）及血小板（PLT）计数等指标。Pearson相关性分析照射时间、剂量及体积与外周血指标之间的相关性。结果：食管癌放疗患者,包括同步放化疗及单纯放疗亚组，在治疗1-6周，照射时间与外周血指标均无相关性（P>0.05）。但在放疗第5-6周，患者放疗剂量与WBC、N、L、HB呈负相关（P<0.05），同步放化疗亚组患者照射剂量与WBC、N、L、HB呈负相关（P<0.05）。在治疗1-4周，不同照射剂量下各梯度照射剂量对应照射体积与外周血指标均无相关性（P>0.05）。但在第5-6周时，患者不同梯度照射剂量下各照射体积与WBC、N呈负相关（P<0.05），同时在20Gy-60Gy照射剂量，尤其20Gy和30Gy照射剂量下照射体积与L呈负相关（P<0.05）。同步放化疗亚组患者不同照射剂量下各照射体积与WBC、N呈负相关（P<0.05），同时在20Gy-60Gy照射剂量下照射体积与L呈负相关（P<0.05），而且在60Gy照射剂量下照射体积与HB呈负相关（P<0.05）。结论：放疗患者特别是同步放化疗亚组患者照射体积、照射剂量与食管癌患者外周血淋巴细胞计数成负相关，基线淋巴细胞与食管癌患者外周血淋巴细胞计数成正相关,而照射时间与食管癌患者外周血淋巴细胞计数无相关性。

Study on the Correlation between Irradiation Volume and Time and the Absolute Value of Peripheral Blood Lymphocytes in Patients with Esophageal Cancer

ABSTRACT Objective: To explore the correlation between the irradiation volume and time and the absolute value of peripheral blood lymphocytes in patients with esophageal cancer. Methods: From January 2019 to December 2019, in the First Affiliated Hospital of Bengbu Medical College, 84 patients with esophageal cancer treated by radiotherapy or combined chemotherapy including 24 patients with radiotherapy alone and 60 patients with radiotherapy combined chemotherapy, were included in the study protocol. The peripheral blood leukocyte (WBC), neutrophil (n), lymphocyte (L), hemoglobin (HB) and platelet (PLT) counts of the patients were measured by blood cell analyzer. Pearson correlation was used to analyze the relationship between irradiation time, dose and volume and peripheral blood parameters. Results: In patients with radiotherapy for esophageal cancer, including the subgroup of concurrent radiotherapy and chemotherapy and radiotherapy alone, there was no correlation between radiation duration and peripheral blood indexes during 1-6 weeks of treatment (P>0.05). However, at the 5-6 weeks of radiotherapy, the radiotherapy dose of patients was negatively correlated with WBC, N, L and HB (P<0.05), while the radiation dose of patients in the concurrent radiotherapy and chemotherapy subgroup was negatively correlated with WBC, N, L and HB (P<0.05). At 1-4 weeks of treatment, there was no correlation between the corresponding irradiation volume of different gradient irradiation doses and peripheral blood indexes (P>0.05). However, at the 5th to 6th week, the exposure volume of patients under different gradient exposure doses was negatively correlated with WBC and N (P<0.05), while the exposure volume under 20Gy-60Gy exposure doses, especially 20Gy and 30Gy exposure doses, was negatively correlated with L (P<0.05). In the concurrent chemoradiotherapy subgroup, the exposure volume was negatively correlated with WBC and N at different exposure doses (P<0.05), while the exposure volume was negatively correlated with L at 20Gy-60Gy exposure dose (P<0.05), and the exposure volume was negatively correlated with HB at 60Gy exposure dose (P<0.05). Conclusion: Radiation volume and dose were negatively correlated with peripheral blood lymphocyte count of patients with esophageal cancer, baseline lymphocytes were positively correlated with peripheral blood lymphocyte count of patients with esophageal cancer, while exposure time was not correlated with peripheral blood lymphocyte count of patients with esophageal cancer.