食管癌患者血清TAP预测放射性肺损伤的临床价值及相关性分析  

Clinical value and correlation analysis of serum TAP in predicting radiation-induced lung injury in patients with esophageal cancer

作　　者：刘学武[1] 刘敏[1] 姜忠于 王立[1] 胡春秀[1] LIU Xuewu;LIU Min;JIANG Zhongyu(Department of Radiotherapy,Zhejiang Quhua Hospital,Quzhou 324004,China)

机构地区：[1]浙江衢化医院放疗科,浙江衢州324004

出　　处：《全科医学临床与教育》2020年第12期1084-1087,1094,共5页Clinical Education of General Practice

基　　金：衢州市科技项目(2018ASA90261);衢州市科技项目(2018ASA90040)。

摘　　要：目的研究食管癌患者血清肿瘤异常蛋白(TAP)预测放射性肺损伤的临床价值及相关性分析。方法选择130例食管癌患者为研究对象,统计放射性肺损伤患者数,评定分级,比较有无放射性肺损伤患者的临床资料;在放疗前、中、后检测患者血清TAP水平,分析患者放射治疗不同时期血清TAP的表达以及不同分级的放射性肺损伤的TAP表达。采用logistic回归进行放射肺损伤多因素分析,ROC曲线评估TAP诊断放射性肺损伤价值,Spearman相关性分析TAP表达与放射性肺损伤。结果130例食管癌患者有65例出现放射性肺损伤,分别为1级13例、2级26例、3级26例。有放射性肺损伤的患者V10、V20、V30、V40以及全肺平均剂量,血清TAP表达明显高于无放射性肺损伤患者(t分别=4.31、9.79、29.56、22.43、22.17、4.98,P均<0.05);各放疗时间食管癌患者的放射性肺损伤分级越高,血清TAP的表达越高(F分别=12.22、13.21、7.89、9.34、8.37、9.22,P均<0.05);并且随着放疗次数的增加,同级肺损伤患者血清的TAP水平逐渐降低(F分别=8.42、9.44、10.22、11.32,P均<0.05);V30、全肺平均放射剂量及血清TAP是患者发生放射性肺损伤的影响因素(OR分别=1.79、2.10、1.91,P均<0.05);血清TAP表达较其他指标于食管癌患者放射性肺损伤有较好诊断价值(诊断特异度87.66%,灵敏度90.23%);血清TAP的表达与患者放疗后发生放射性肺损伤程度呈正相关(rs=0.45,P<0.05)。结论食管癌患者不同放疗时期血清TAP表达对于肺损伤具有较好的临床诊断价值,且血清TAP是放射性肺损伤的影响因素,TAP或可成为临床控制食管癌患者发生放射性肺损伤的靶标因子。Objective To explore the clinical value and correlation of serum TAP in predicting radiation-induced lung injury in esophageal cancer patients.Methods The 130 cases with esophageal cancer were collected,and the patients with radiation-induced lung injury were counted and graded.And the clinical data between patients with radiation-induced lung injury and patients without radiation-induced lung injury were compared.The levels of serum TAP were measured before,during and after radiotherapy.The expression of serum TAP among different times and different grades of radiation-induced lung injury were compared.Logistic was used to analyze the risk factors of radiation-induced lung injury.ROC curve was used to evaluate the diagnostic value of TAP in radiation-induced lung injury.Spearman correlation analysis was used to analyze the expression of TAP and radiation-induced lung injury.Results There were 65 cases of radiation lung injury in 130 patients with esophageal cancer,including 13 cases of grade 1,26 cases of grade 2 and 26 cases of grade 3.The levels of V10,V20,V30,V40,the average dose,and the expression of serum TAP of whole lung in patients with radiation-induced lung injury were significantly higher than those without radiation-induced lung injury(t=4.31,9.79,29.56,22.43,22.17,4.98,P<0.05).The higher the grade of radiation-induced lung injury in patients with esophageal cancer,the higher the expression of serum TAP(F=12.22,13.21,7.89,9.34,8.37,9.22,P<0.05).With the increase of the times of radiotherapy,the level of serum TAP in patients with same grade lung injury decreased gradually(F=8.42,9.44,10.22,11.32,P<0.05),The V30,average radiation dose of whole lung,and serum TAP were the influencing factors of radiation-induced lung injury in patients with radiation-induced lung injury(OR=1.79,2.10,1.91,P<0.05).Compared with other indexes,the expression of serum TAP has better diagnostic value in radiation-induced lung injury in patients with esophageal cancer,its diagnostic specificity was 87.66%,the sensitivity was

关 键 词：食管癌 血清肿瘤异常蛋白 放射性肺损伤 相关性 

分 类 号：R735.1[医药卫生—肿瘤]