食管癌和肺癌患者血清IL-10、MMP-9、TNF-α预测放射性肺炎临床观察  

Clinical observation on prognosis of serum IL-10,MMP-9,TNF-α in radiation pneumonitis for patients with lung or esophageal cancer

作　　者：常晓龙 文景丽 郭英华[1] 李建文[1] 刘杰[1] 姜迎宵[1] 马瑞忠[1] 郝福荣[1] 王明臣[1] CHANG Xiaolong;WEN Jingli;GUO Yinghua;LI Jianwen;LIU Jie;JIANG Yingxiao;MA Ruizhong;HAO Furong;WANG Mingchen(Department of Radiation Oncology,Weifang People’s Hospital,Weifang 261041,China;Department of Medical Oncology,Dongying People’s Hospital)

机构地区：[1]潍坊市人民医院放疗科,山东潍坊261041 [2]东营市人民医院肿瘤科

出　　处：《潍坊医学院学报》2019年第4期283-287,共5页Acta Academiae Medicinae Weifang

基　　金：潍坊市科技发展计划(项目编号:201302007)

摘　　要：目的研究食管癌和肺癌患者血清中白介素-10(IL-10)、基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)浓度与放射性肺炎(RP)发生的关系,探索上述细胞因子对RP的预测价值。方法收集自2014年3月1日~2014年7月31日就诊于潍坊市人民医院放疗科的原发性肺癌及食管癌放疗患者,观察并记录RP的发生情况。采用酶联免疫吸附法(ELISA)检测血清中IL-10、MMP-9、TNF-α浓度。依照美国肿瘤放射治疗协作组(RTOG)分级标准评价急性放射性肺损伤,观察终点为≥2级RP。结果共收集原发性肺癌及食管癌患者30例,剔除10例,纳入分析20例,中位随访时间4个月(1~5.3个月),随访率为100%.20例患者中9例(45%)发生RP,1级7例(35%),2级2例(10%),无≥3级及以上急性RP发生。各级RP间在年龄(≥60岁与<60岁)、性别、吸烟史、化疗史、放疗总剂量(≥60Gy与<60Gy)、病种类型方面均无统计学差异(P>0.05)。配伍组方差分析显示,放疗不同时期食管癌和肺癌患者3细胞因子血清浓度不同程度波动,但仅TNF-α血清浓度有统计学差异(P=0.020)。以放疗时期、RP分级为影响因素的双因素方差分析显示,3种细胞因子放疗不同时期间血清浓度仅TNF-α的差异有显著性(P=0.038),不同级别RP间3种细胞因子血清浓度仅IL-10的差别有显著性(P=0.037),进一步行两两比较示2级RP与1级RP、无RP患者血清IL-10浓度有显著差别(P<0.05)。以检测时间为控制因素的偏相关分析发现,RP分级仅与血清IL-10浓度呈偏正相关(P<0.05)。结论食管癌和肺癌放疗患者各级RP间血清IL-10浓度有显著差异,并且二者呈偏正相关关系,有望成为便捷预测RP的预测因子。Objective In order to explore prognosis of serum IL-10,MMP-9,TNF-α in radiation pneumonitis for patients with lung or esophageal cancer.Methods Patients with lung or esophageal cancer treated with radiotherapy between Mar 1,2014,and Jul 31,2014 were enrolled at the Department of Radiation Oncology of Weifang People’s Hospital.The level of serum TNF-α,MMP-9,IL-10 was detected by ELISA.RP were graded according to the Radiation Therapy Oncology Group(RTOG) acute radiation morbidity scoring criteria.The end points were Grade 2 or above RP.Results Thirty patients were enrolled,10 patients were excluded,finally 20 patients were analyzed.The median follow-up time was 4(1~5.3) months,the follow-up rate was 100%.9 of 20 patients(45.0%) experienced RP,7(35.0%) patients with grade 1 RP,2(10.0%) patients with grade 2 RP,and none with more than grade 2 RP.There was no statistical difference among different grade RP regarding age(≥60 years or <60 years),sex,history of smoking,history of chemotherapy,total dose of radiotherapy(≥60 Gy or <60 Gy),disease type(lung or esophageal cancer)(P>0.05).The concentration of IL-10,MMP-9 in the serum of patients with lung or esophageal cancer before radiotherapy was fluctuated during or after radiotherapy,but statistical difference was only observed for TNF-α by Compatibility group Analysis of Variance(P<0.05).Only the serum concentration of TNF-α were significantly varied among different radiotherapy period(P=0.038),only that of IL-10 were significantly varied among different grade RP(P=0.037) applying Two-Way Analysis of Variance selecting radiotherapy period and RP grade as factors,with statistical difference between grade 2 RP and grade 1 RP or no RP(P<0.05).RP scales were only correlated with IL-10(P<0.05) by Partial Correlations Analysis controlling for radiotherapy period.Conclusion In the serum of patients with lung or esophageal cancer,the concentration of IL-10 were significantly varied among different grade RP,and were partially positively correlated with RP scales.So IL

关 键 词：肺癌 食管癌 放射性肺炎 IL-10 TNF-Α MMP-9 

分 类 号：R730.55[医药卫生—肿瘤]