口腔癌术后化疗早期血小板升高相关因素研究

目的：探讨口腔癌患者术后化疗早期血小板升高的意义。方法：查阅2008年1月至2011年1月在我院行术后化疗的86例口腔癌患者病历资料，统计化疗前及化疗第一至四周期PLT数，探寻血小板数（Platdets，PLT）的变化规律；选取2011年8月至2012年7月在我院行术后化疗46例口腔癌患者，20例健康人作为对照组，晨起空腹采血，检测血液常规，分离血清，ELISA法检测血清中Fit-3配体（Flt-3 ligand，FL）及血小板生成素（Thrombopoietin，TPO）含量。结果：①2008年1月至2011年1月86例口腔癌患者有27例化疗期间出现PLT先升高再降低的现象，且升高较化疗前具有显著性（P〈0．05）。②2011年8月至2012年7月46例口腔癌患者化疗前PLT各参数与对照组均无明显差异（P〉0．05），而化疗后与化疔前相比，PLT、血小板压积（Platecrit，PCT）明显升高（P〈0．05），血小板平均体积（MeanPlateletVolume，MPV）、血小板分布宽度（Platelet distribution width，PDW）则明显降低（P〈0．05）；化疗前血清中FL、TPO与对照组无明显差异（P〉0．05），化疗后与化疗前相比，FL明显降低（P〈0．05），TPO差异不具有显著性（P〉0．05）。结论：术后11．5个月行化疗时，骨髓造血功能已基本恢复正常，而化疗后骨髓造血功能确实受到一定的抑制；化疗早期血小板升高是由于外周血中血小板破坏减少，而非骨髓生成血小板增多所致；化疗早期血小板升高不能代表肿瘤治疗无效，或者癌细胞发生转移。

Related factors research of inceased platelet in primary chemotherapy of oral cancer patients

Objective：To explore the significance of increased platelets counts in oral cancer patients undergoing primary chemotherapy. Methods： In the period from 2008.1 to 2011.1, the case histories of 86 patients with oral cancer, which underdid chemotherapy after surgery , were collected to analysis the variation of the PLT counts, including prechemotherapy and the intermission of the chemotherapy; The blood collection was performed in another 46 patients with the same experience in the period from 2011.8 to 2012.7, to the detect blood routine,and FL, TPO contents in serum by enzyme-linked immunosorbent assay（ ELISA）. 20 healthy people with accordant sex and age were controed. Results： 1. During the chemotherapy stage, the PLT of the 86 patients increased at first and then decreased, further more, compared with pre - chemotherapy, the increasion of PLT was significance（ P 〈 0.. 05 ）. 2. For the 46 patients, there is no significant difference in platelet parameters, FL and TPO pre - chemotherapy, compared with healthy people （ P 〉 0.05 } ; however, compared with pre - chemotherapy, the PLT and PCT were increased （ P 〈 0.05 ） , while MPV、 PDW and FL decreased significantly （ P 〈 0.05 ）. There is no significant difference in TPO parameter between pre - and after- chemotheraty. Conclusion：After 1 - 1.5 months, the bone marrow＇ s blood producing function of the operated patients has recovered to normal level before chemotheraty, while this function is indeed inhibited after chemotheraty; The increase of PLT in early stage of chemotheraty was caused by the decreased peripheral platelet destruction, not the bone marrow; The increase of PLT in early stage of chemotheraty does not stand for invalid of tumor treatment, or metastasis.