肺癌化疗患者RET、Cr/CysC、Nrf2mRNA水平变化及预测骨髓抑制的价值

目的:探讨肺癌化疗患者网织红细胞比率（RET）、肌酐（Cr）/胱抑素C（CysC）、核因子E2相关因子2（Nrf2）mRNA水平变化及预测骨髓抑制的价值。方法:选取2018年1月-2021年3月我院肺癌化疗患者125例为研究对象，根据是否发生骨髓抑制分为骨髓抑制组（n=72）、正常组（n=53）。比较两组一般资料、化疗前后RET、Cr/CysC、Nrf2mRNA水平，分析化疗前RET、Cr/CysC、Nrf2mRNA水平与骨髓抑制分级的相关性，Logistic回归分析肺癌化疗后骨髓抑制影响因素，ROC分析化疗前RET、Cr/CysC、Nrf2mRNA对骨髓抑制的预测价值。结果:骨髓抑制组化疗前后RET、Cr/CysC、Nrf2mRNA水平低于正常组（P＜0.05）；化疗前RET、Cr/CysC、Nrf2mRNA水平与骨髓抑制分级呈负相关（P＜0.05）；化疗前RET、Cr/CysC、Nrf2mRNA水平均与肺癌患者化疗后骨髓抑制有关（P＜0.05）；化疗前RET、Cr/CysC、Nrf2mRNA联合预测肺癌患者化疗骨髓抑制的AUC值高于单独预测。结论:肺癌患者化疗后RET、Cr/CysC、Nrf2mRNA水平均降低，且与骨髓抑制发生及其严重程度有关，化疗前检测上述指标水平可有效预测骨髓抑制发生风险。

Changes of RET,Cr/CysC,Nrf2mRNA levels in patients with lung cancer chemotherapy and analysis of the value of predicting bone marrow suppression

Objective:To investigate the changes of reticulocyte ratio(RET),creatinine(Cr)/cystatin C(CysC),nuclear factor E2-related factor 2(Nrf2) mRNA levels and the value of predicting bone marrow suppression in patients with lung cancer chemotherapy.Methods:The clinical data of 125 patients with lung cancer chemotherapy in our hospital from January 2018 to March 2021 were retrospectively analyzed,according to whether bone marrow suppression occurred,they were divided into bone marrow suppression group (n=72) and normal group (n=53).Compare the general information of the two groups,the levels of RET,Cr/CysC,and Nrf2mRNA before and after chemotherapy,analyze the correlation between RET,Cr/CysC,Nrf2mRNA levels and the grade of bone marrow suppression before chemotherapy.Logistic regression analysis of influencing factors of bone marrow suppression after lung cancer chemotherapy.Receiver operating characteristic (ROC) curves analyzed the predictive value of RET,Cr/CysC,and Nrf2mRNA on myelosuppression before chemotherapy.Results:The levels of RET,Cr/CysC and Nrf2mRNA before and after chemotherapy were lower than those of the normal group (P＜0.05).The levels of RET,Cr/CysC,and Nrf2mRNA before chemotherapy were negatively correlated with the grade of bone marrow suppression (P＜0.05).The levels of RET,Cr/CysC,and Nrf2mRNA before chemotherapy were related to bone marrow suppression in lung cancer patients after chemotherapy (P＜0.05).The combination of RET,Cr/CysC,and Nrf2mRNA before chemotherapy predicts that the AUC value of bone marrow suppression in patients with lung cancer was higher than that predicted alone.Conclusion:The levels of RET,Cr/CysC,and Nrf2mRNA in lung cancer patients decrease after chemotherapy,and they are related to the occurrence and severity of bone marrow suppression.The detection of the above index levels before chemotherapy can effectively predict the risk of bone marrow suppression.