检验医学 ›› 2016, Vol. 31 ›› Issue (5): 359-362.DOI: 10.3969/j.issn.1673-8640.2016.05.004

• 临床应用研究·论著 • 上一篇    下一篇

网织红细胞计数在肿瘤患者化疗监测中的临床价值

张拥黎, 卢仁泉, 周磊, 郭林   

  1. 复旦大学附属肿瘤医院检验科 复旦大学上海医学院肿瘤学系,上海 200032
  • 收稿日期:2015-12-31 出版日期:2016-05-30 发布日期:2016-06-13
  • 作者简介:null

    作者简介:张拥黎,男,1978年生,学士,技师,主要从事临床检验工作。

    通讯作者:郭 林,联系电话:021-64175590-82204。

Significance of monitoring reticulocyte count during chemotherapy for patients with cancer

ZHANG Yongli, LU Renquan, ZHOU Lei, GUO Lin   

  1. Department of Clinical Laboratory, Shanghai Cancer Center,Fudan University/Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China
  • Received:2015-12-31 Online:2016-05-30 Published:2016-06-13

摘要:

目的 监测肿瘤患者化疗过程中网织红细胞(RET)的变化情况,评估RET作为骨髓造血功能抑制与恢复早期预测指标的价值。方法 肿瘤患者化疗均以21 d为1个治疗周期,其中第0天为化疗前,第1~3天采用化学药物治疗,第7~21天为化疗后。采用SYSMEX XE-4000全自动血液分析仪(简称XE-4000)检测48例肿瘤患者化疗前、后RET百分比(RET%)的变化,并与传统手工计数进行比较。同时检测外周血红细胞(RBC)、白细胞(WBC)数量。根据第10天RET%升高是否超过25%将48例肿瘤患者分为RET明显升高组(RET%升高≥25%)和RET升高不明显组(RET%升高<25%),分析2个组外周血RBC、WBC的变化情况。结果 XE-4000 RET%检测结果与手工计数法基本一致。肿瘤患者化疗后发生不同程度的骨髓造血功能抑制,随访显示第7天、第10天外周血RBC、WBC计数和RET%均低于化疗前(P<0.05);随后,RBC计数随RET%的升高而升高。RET明显升高组第21天的RBC计数结果明显高于化疗前(P<0.05),而RET升高不明显组第21天RBC计数虽有升高,但差异无统计学意义(P>0.05)。化疗后RET明显升高组WBC在骨髓恢复期的早期即已升高,但波动范围较大;而RBC则稍晚升高。RET升高不明显组WBC升高时间较晚,RBC基本无变化。结论 RET计数可作为肿瘤患者化疗后反映骨髓抑制或恢复较敏感的指标。

关键词: 网织红细胞, 红细胞, 白细胞, 恶性肿瘤, 化学治疗

Abstract:

Objective To monitor the change of reticulocyte(RET)count during chemotherapy for cancer patients,and evaluate RET count as an early indicator of bone marrow arrest and recovery. Methods Twenty-one d is a treatment cycle of chemotherapy for all cancer patients in this study,while the 0th day was defined as pre-chemotherapy,chemotherapy was conducted on the 1st day to 3rd day,and the 7th day to 21st day were as post-chemotherapy. RET percentages (RET%) of 48 cancer patients before and after chemotherapy were determined by SYSMEX XE-4000 automatic hematology analyzer (XE-4000),and compared with traditional manual counting for RET. Red blood cell(RBC)and white blood cell(WBC)counts were determined. These 48 cancer patients were classified into 2 groups according to RET% on the 10th day,high-elevated RET group (RET% increased≥25%)and low-elevated RET group (RET% increased <25%). The changes of RBC and WBC counts between the 2 groups were analyzed. Results RET% by XE-4000 was in accordance with that by manual counting. Since bone marrow arrest occurred after chemotherapy,RBC count,WBC count and RET% on the 7th and 10th day were lower than those before chemotherapy(P<0.05). RBC count increased with the elevation of RET%,especially on the 21st day,which was higher than that before chemotherapy(P<0.05). Although RET count increased on the 21st day,there was no statistical significance in low-elevated RET group(P>0.05). In high-elevated RET group,WBC count increased and fluctuated significantly during bone marrow recovery,and then RBC count increased. In contrast to high-elevated RET group,WBC count in low-elevated RET group increased later,along with slight change in RBC count. Conclusions RET count might act as an early indicator of bone marrow arrest and recovery after chemotherapy.

Key words: Reticulocytes, Red blood cells, White blood cells, Neoplasms, Chemotherapy

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