C反应蛋白与放疗皮肤反应相关性研究  

Clinical study of correlation between serum levels of C- reactive protein/high - sensitivity C- reactive protein and radiation dermatitis

作　　者：李博[1] 陈火明[1] 张瑞娟[1] 安娟[1] 李治桦[1] 段文博[1] 林小华[1] 

机构地区：[1]中国人民解放军第二炮兵总医院肿瘤科,北京100088

出　　处：《现代肿瘤医学》2012年第3期600-602,共3页Journal of Modern Oncology

摘　　要：目的:探讨C反应蛋白(CRP)和超敏C反应蛋白(hs-CRP)与放疗皮肤反应之间的相关性。方法:观察103例接受放疗的恶性肿瘤患者的皮肤反应,同时每周检测患者血清中CRP和hs-CRP水平。结果:接受立体定向放疗(SRT)患者的CRP(54.6±10.9 vs 17.3±2.5,P=0.004)和hs-CRP(10.4±1.9 vs 5.6±0.6,P=0.017)水平明显高于接受直线加速器放疗(RT)患者。SRT患者皮肤反应均为0度,RT患者2例皮肤反应为0度,25例为Ⅰ度,29例为Ⅱ度,19例为Ⅲ度,6例为Ⅳ度。对于RT患者,CRP(相关系数0.48,P<0.001)及hs-CRP水平(相关系数0.25,P=0.05)随皮肤反应级别的增高而增高,其中Ⅱ度以上皮肤损伤患者的CRP水平明显高于Ⅱ度以下患者(33.5±5.9 vs 10.1±1.8,P=0.001),而hs-CRP水平在这两部分人群中差异不明显(7.5±1.2 vs 4.9±0.7,P=0.06)。结论:放疗可导致CRP和hs-CRP水平增高,其增高与SRT患者皮肤反应无关,而与RT患者皮肤反应呈正相关,其中CRP水平在Ⅱ度以上和Ⅱ度以下皮肤反应患者之间的差异具有统计学显著性。Objective：To explore the correlation between serum levels of C-reactive protein（CRP）/high-sensitivity C-reactive protein（hs-CRP） and radiation dermatitis.Methods：One hundred and three patients with carcinoma were included.Stereotactic radiotherapy（SRT） was applied for 22 patients and radiation therapy（RT） for 81 patients.Weekly,radiation dermatitis was assessed according to EORTC（European Organization for Research and Treatment of Cancer） criteria and serum CRP/hs-CRP were tested.Results：The mean serum levels of CRP（54.6 ± 10.9 vs 17.3 ± 2.5,P = 0.004）/hs-CRP（10.4 ± 1.9 vs 5.6 ± 0.6,P = 0.017） for SRT-treating patients were significantly higher than those treated with RT.In terms of radiation dermatitis,none was seen for SRT-treating patients.For RT-treating patients,grade 0 dermatitis was seen in 2 patients,gradeⅠin 25,gradeⅡin 29,grade Ⅲ in 19 and grade Ⅳ in 6.The mean serum levels of CRP/hs-CRP were escalated with the severity of radiation dermatitis（CRP：correlation coefficient 0.48,P 0.001;hs-CRP：correlation coefficient 0.25,P = 0.05）.And patients with grade 3 /4 dermatitis had significantly higher mean serum level of CRP than those with grade 2 or lower dermatitis（33.5 ± 5.9 vs 10.1 ± 1.8,P = 0.001）.However,for hs-CRP,the difference was not significant（7.5 ± 1.2 vs 4.9 ± 0.7,P = 0.06）.Conclusion：Serum level of CRP/hs-CRP increased after radiation.They had positive correlation with the severity of radiation dermatitis in RT-treating patients.Serum level of CRP was significantly higher in patients with grade 3 /4 dermatitis than those with grade 2 or lower dermatitis.However,no such correlation was found in SRT-treating patients.

关 键 词：肿瘤 放疗 皮肤损伤 C反应蛋白 

分 类 号：R730.55[医药卫生—肿瘤]