血浆TGF-β1与放射性肺损伤的相关性研究  

Relationship between the Plasma Transforming Growth Factor-β1 Levels and Radiation-Induced Lung Injury

作　　者：钟军[1] 刘珺[1] 陈文学[1] 王小平[1] 罗辉[1] 刘明之[1] 刘智华[1] 

机构地区：[1]江西省肿瘤医院,330029

出　　处：《实用癌症杂志》2007年第5期468-471,共4页The Practical Journal of Cancer

摘　　要：目的探讨放疗前后血浆TGF-β1的水平和V20与发生放射性肺损伤的相关性。方法受三维适形放疗的53例肺癌患者,肿瘤总照射剂量40～70Gy,常规分割2Gy/次,5次/周。计划控制V20≤35%,脊髓剂量≤45Gy。应用ELISA方法对患者放疗前后血浆TGF-β1的浓度进行定量检测。结果全组放射性肺损伤的发生率为32.1%(17/53),其中Ⅱ级或Ⅱ级以上发生率为13.2%。放疗结束时,TGF-β1水平升高者放射性肺损伤的发生率为51.9%,明显高于TGF-β1水平正常者(11.5%)(P=0.002),而放疗前TGF-β1水平升高或在正常范围,放射性肺损伤发生率无显著差异(P=0.315)。V20>25%,放疗结束时TGF-β1水平升高,放射性肺损伤的发生率为62.5%,明显高于其它组别;而V20≤25%,放疗结束时血浆TGF-β1正常的患者没有发生放射性肺损伤。结论放疗结束时TGF-β1水平升高与放射性肺损伤密切相关。V20>25%,放疗结束时TGF-β水平升高者,属于发生放射性肺损伤的高危人群。Objective To investigate the relationship between the pre- and posttreatment plasma TGF-β1 levels, V20 and radiation-induced lung injury. Methods Fifty-three patients with lung cancer receiving 3DCRT were included in this study. The radiation was delivered in 2Gy per fraction,5 fractions per weeks, with a total dose from 40 to 70Gy. The percentage of both lung volume receiving 20Gy or more （V20） was restricted to 35% or less,and dose to the spinal cord was restricted to 45Gy. Concentrations of pre- and posttreatment plasma TGF-β1 were quantified by. ELISA. Results The radiation induced lung injury was noted in 35.7% （ 17/53 ） patients, and 13.2% patients developped Grade 2 or worse radiation-induced lung injury. The incidence of the radiation induced lung injury was 51.9 % in patients with elevated posttreatment TGF-β1 levels, and this was significantly higher than those with normal TGF-β1 levels（ 11.5% ） （ P = 0.002 ）. The pre-treatment TGF-β1 levels had no correlation with radiation-induced lung injury（ P =0. 315 ）. The radiation-induced lung injury developped in 62.5% patients with V20 〉 25 % and elevated post- treatment TGF-β1 levels, and this was significantly higher than those of other groups. None of the patients with V20 ≤25% and normal post-treatment TGF-β1 levels developped radiation-induced lung injury. Conclusion Radiation-induced lung injury is related to the plasma TGF-β1 levels at the end of radiation. Patients with V20 〉25% and elevated posttreatment TGF-β1 levels are at especially high risk to develop radiation induced lung injury.

关 键 词：放射性肺损伤 转化生长因子-Β1 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]