外周血TNF-α、TGF-β、IL-6水平及DVH参数与放射性肺损伤关系研究  

A Correlation Study of Peripheral Blood TNF- α、TGF- β、IL- 6 Levels and Dose- volume to radiation induced lung injury

作　　者：吕茵[1] 曾敏[1] 张瑾熔[1] 

机构地区：[1]新疆医科大学附属肿瘤医院胸腹放疗科,新疆乌鲁木齐830011

出　　处：《吉林医学》2014年第8期1585-1587,共3页Jilin Medical Journal

基　　金：新疆医科大学创新基金项目[项目编号:XJC201035)]

摘　　要：目的：研究肺癌患者血浆中TNF-α、TGF-β、IL-6水平及DVH参数与放射性肺损伤（RILI）发生的关系.方法：回顾性分析70例肺癌患者放疗前及照射45～50 Gy时血浆中TNF-α、TGF-β、IL-6的含量;DVH参数包括V5,V10,V20,V30,V40及MLD与RILI的发生情况.观察终点为≥1 级RILI.结果：70例患者中有25例发生了RILI,单因素分析显示,放疗前血浆中IL-6基础水平、MLD是RILI发生的相关因素（P＜0.05）.多因素分析显示放射治疗前IL-6水平较高可能是RILI发生的独立危险因素（OR值分别为1.050,P＜0.05）.结论：放射治疗前IL-6高水平发生RILI的风险较高,该发现对临床有一定指导意义.Objective To study the relationship between the level of plasma tumor necrosis factor-α（TNF-α）,transform growth factor beta （TGF-β）, interleukin-6 （IL-6）,DVH and radiation induced lung injury （RILI）.Method 70 lung cancer patients treated with intensity modulated radiation therapy were retrospectively collected and analyzed.Enzyme-linked immunosorbent assay （ELISA） was utilized to detect the levels of plasma TNF-α,TGF-β and IL-6 in patients before radiotherapy （pre-RT） and when radiotherapy does reached 45-50 Gy （during-RT）.DVH parameters include V5,V10,V20,V30,V40 and MLD.According to the RTOG morbidity scoring classification,radiation pneumonitis was classified.Either Grade 1 or more RILI was taken as the main end point.Results 25 of 70 patients had RILI,Univariate analysis demonstrated that the RILI incidence was associated with pre-RT levels of plasma IL-6,MLD（P＜0.05）.Multivariate analysis showed that pre-RT higher levels of plasma IL-6 was independently associated with RILI （OR=1.050,P＜0.05）.Conclusion These results indicated that pre-RT higher levels of plasma IL-6 was found to confer significantly increased risk of the RILI,which could serve as the guidance of clinical treatment.

关 键 词：肺癌 放射治疗 放射性肺损伤 细胞因子 

分 类 号：R734.2[医药卫生—肿瘤]