Risk Factors Of Myelosuppression In Patients With Lung Cancer After Chemotherapy And Correlation With New Inflammatory Indexes

Objective:To investigate the risk factors of bone marrow suppression caused by chemotherapy in patients with lung cancer and the correlation between the occurrence time of the most severe bone marrow suppression and various inflammatory indexes（FBG,NLR,LMR,PLR）Methods:Collect the clinical data of 177 patients with lung cancer who had received at least 4courses of complete chemotherapy in early and late stage（stage IB-IV）in our hospital from March 2018 to October 2021;Lung cancer characteristics;Relevant inspection indicators;Blood count before chemotherapy,such as NLR,PLR,LMR;The patients were divided into two groups according to the severity and time of the decline of the indicators of bone marrow suppression after chemotherapy.The correlation between the inflammatory indicators before chemotherapy and the basic data of patients was analyzed,and the regression model was analyzed for single and multiple factor analysis.To evaluate the effects of basic data of patients before basic chemotherapy,relevant test indexes and relevant inflammatory indexes such as FBG,NLR,LMR and PLR on the degree and time of bone marrow suppression after chemotherapy.The test standard was set as P < 0.05.Results:（1）Univariate analysis showed that in the basic data,gender（P = 0.049 < 0.05）,basic diseases（P = 0.019 < 0.05）,AST（P = 0.003 < 0.05）,ALT（P = 0.042 < 0.05）,γ-GT（P =0.002 < 0.05）,traditional inflammatory index FBG（P = 0.001 < 0.05）,new inflammatory index NLR,PLR,LMR（P < 0.001）and the risk of granulocyte deficiency were statistically significant;In the basic data,whether there is basic disease in the stage（P = 0.001 < 0.05）（P= 0.019 < 0.05）,LDL / HDL（P = 0.016 < 0.05）,traditional inflammatory index FBG（P =0.001 < 0.05）,new inflammatory index（P < 0.05）and the risk of platelet decline after chemotherapy were statistically significant.Patients with higher stage,basic disease,greater LDL / HDL and FBG,and higher new inflammatory index were at higher risk of thrombocytopenia after chemotherapy;Among the experimental indexes,the white bulbratio（P = 0.012 < 0.05）,TG triglyceride（P = 0.035 < 0.05）,new inflammatory indexes NLR,PLR and LMR（P < 0.001）were statistically significant with the decrease of hemoglobin after chemotherapy,Patients with higher WBR,TG and new inflammatory indexes were at higher risk of hemoglobin decline after chemotherapy.（2）The results of binary logistic regression analysis showed that the OR value of NLR was 8.159（3.027-21.99）,P < 0.001;the OR value of PLR was 1.011（1.003-1.02）,P = 0.007< 0.05;The OR value of gender was 0.33 < 1,P = 0.028 < 0.05;The OR value of basic disease was 2.543（1.036-6.241）,P = 0.042 < 0.05,and NLR group P = 0.003,suggesting that NLR,high NLR group,PLR,gender,male and the presence of basic disease were independent risk factors.In the risk of thrombocytopenia after chemotherapy,the OR value of PLR was 1.032（1.009-1.054）,P = 0.005 < 0.05;the OR value of basic disease was 4.185（1.163-15.055）,P = 0.028 < 0.05,and P = 0.028,suggesting that PLR,high PLR group and basic disease are independent risk factors.The OR value of LMR in the risk of hemoglobin reduction after chemotherapy was 7.254（2.823-18.645）,P < 0.001 < 0.05,suggesting that LMR is an independent risk factor.（3）The occurrence time of the most serious course of bone marrow suppression was analyzed by univariate analysis,and then linear regression was used for regression fitting.NLR（P < 0.001）,NLR group（P < 0.001）,FBG（P = 0.046 < 0.05）,basic disease（P < 0.05）and the treatment course of granulocyte deficiency after chemotherapy were statistically significant and negatively correlated.In NLR group（beta =-0.297）,the larger NLR,higher NLR group（greater than 2.45）,larger FBG and the earlier treatment course of basic disease.LMR（P < 0.001）and LMR group（P < 0.001）were statistically significant and negatively correlated with the course of treatment when the hemoglobin decreased most seriously after chemotherapy.In LMR group（beta =-0.506）,the greater the LMR and the higher the LMR group（greater than 3.62）,the earlier the course of treatment.PLR（P < 0.001）and PLR group（P < 0.001）were statistically significant and negatively correlated with the course of treatment when thrombocytopenia was the most serious after chemotherapy.In PLR group（beta =-0408）,the greater PLR and high PLR group（greater than 148.82）had earlier course of treatment.Conclusion:（1）NLR,high NLR group,PLR,male,presence of underlying diseases were independent risk factors for the severity of granulocyte deficiency after chemotherapy.PLR,high PLR group and basic diseases were independent risk factors for hemoglobin decline after chemotherapy.LMR is an independent risk factor for thrombocytopenia after chemotherapy.（2）NLR,LMR and PLR can respectively predict the time（course of treatment）of the most serious bone marrow suppression after chemotherapy.