Abstract: Background　Accurate assessment of expected survival in patients with advanced cancer is important to improve their quality of life.However，current tools for predicting the survival of these patients need to be improved.Objective　To explore the relationship between laboratory test indices and survival status of advanced cancer patients.Methods　Totally 175 advanced cancer patients were recruited from Hospice Ward，Linfen Community Health Center，Shanghai's Jing'an District，from 2018-11-01 to 2019-06-31.Admission laboratory test results were collected，including white blood cell count，hemoglobin，lymphocyte count，neutrophil count，platelet count，C-reactive protein，serum albumin，neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.The follow-up was conducted until September 30，2019.The end point for follow-up was death.Cox regression analysis was used to examine the association of each laboratory indicator with the survival status.Results　Of the 175 cases，150 died in hospital，with a median survival of 8 days（range，1-29 days），other 25 were lost to follow-up after discharge，with a median length of stay of 67.5 days（range，30-167 days）.Univariate Cox regression analysis showed that high white blood cell count，neutrophils count and C-reactive protein，and low lymphocyte count，platelet count，and serum albumin were associated with the survival status of advance cancer patients（P<0.05）.Multivariate Cox regression analysis showed that lymphocyte count 〔low：HR=1.498，95%CI （1.035，2.170），P=0.032；high：HR=8.490，95%CI （1.894，38.057），P=0.005〕，neutrophil count 〔high：HR=2.227，95%CI （1.478，3.357），P<0.001〕，platelet count 〔low：HR=2.185，95%CI （1.418，3.366），P<0.001〕，and C-reactive protein 〔high：HR=1.478，95%CI （1.005，2.201），P=0.047〕 were independently associated with the survival status of advance cancer patients.Conclusion　Lymphocyte count，neutrophil count，platelet count and C-reactive protein are independently associated with survival status of patients with advanced cancer，may have a certain value in assessing the survival status.

Key words: Neoplasms, Survival, Hospice care, Lymphocyte count, Neutrophil count, Patelet count, C-reactive protein, Root cause analysis

摘要： 背景　准确评估晚期癌症患者的预期生存情况对提高其生存质量有重要意义，但目前预测晚期癌症患者生存情况的工具尚有待改善。目的　探索实验室检查指标与晚期癌症患者生存情况的关系。方法　选取2018-11-01至2019-06-31入住上海市静安区临汾路街道社区卫生服务中心安宁疗护病房的晚期癌症患者175例，收集其入院时相关实验室检查指标〔白细胞计数、血红蛋白、淋巴细胞计数、中性粒细胞计数、血小板计数、C反应蛋白、血清白蛋白、中性粒细胞计数/淋巴细胞计数（NLR）和血小板计数／淋巴细胞计数（PLR）〕。随访截至2019-09-30，随访终点事件为死亡。采用Cox回归分析探究各实验室指标是否为晚期癌症患者生存情况的独立影响因素。结果　175例患者中在院死亡150例，出院失访25例。在院死亡患者生存期为1~29 d，中位生存期为8 d；出院失访患者住院时间为30~167 d，中位住院时间为67.5 d。单因素Cox回归分析结果显示，白细胞计数偏高、淋巴细胞计数偏低、中性粒细胞计数偏高、血小板计数偏低、C反应蛋白偏高、血清白蛋白偏低是晚期癌症患者生存情况的影响因素（P<0.05）。多因素Cox回归分析结果显示，淋巴细胞计数〔偏低：HR=1.498，95%CI（1.035，2.170），P=0.032；偏高：HR=8.490，95%CI（1.894，38.057），P=0.005）〕、中性粒细胞计数〔偏高：HR=2.227，95%CI（1.478，3.357），P<0.001〕、血小板计数〔偏低：HR=2.185，95%CI（1.418，3.366），P<0.001〕、C反应蛋白〔偏高：HR=1.478，95%CI（1.005，2.201），P=0.047〕是晚期癌症患者生存情况的独立影响因素。结论　淋巴细胞计数、中性粒细胞计数、血小板计数及C反应蛋白是晚期癌症患者生存情况的独立影响因素，对于评估患者生存情况有一定应用价值。

关键词: 肿瘤, 生存期, 安宁疗护, 淋巴细胞计数, 中性粒细胞计数, 血小板计数, C反应蛋白, 影响因素分析