炎症因子与乳腺癌患者辅助放射治疗期间癌性疲劳的相关性  

Correlation between inflammatory cytokines and cancer-related fatigue in breast cancer patients undergoing adjuvant radiotherapy

作　　者：刘秋霞[1] 孙彩萍[1] 叶万立[2] 徐俊[2] 朱晓灵[1] 刘建江[2] 孙红岗[3] 王建芳[1] Liu Qiuxia;Sun Caiping;Ye Wanli;Xu Jun;Zhu Xiaoling;Liu Jianjiang;Sun Honggang;Wang Jianfang(Shaoxing People’s Hospital(Shaoxing Hospital of Zhejiang University),Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)肿瘤内科,绍兴312000 [2]绍兴市人民医院(浙江大学绍兴医院)放疗科,绍兴312000 [3]绍兴市人民医院(浙江大学绍兴医院)检验科,绍兴312000

出　　处：《新医学》2021年第6期421-425,共5页Journal of New Medicine

基　　金：浙江省医药卫生科研面上项目(2018KY832);浙江省医药卫生科研面上项目(2019KY228);绍兴市院级青年基金(2017B02)。

摘　　要：目的探讨炎症因子与乳腺癌患者辅助放射治疗期间癌性疲劳的相关性。方法选取术后辅助放射治疗的乳腺癌患者,按埃德蒙顿症状评估系统的疲劳评分将其分为疲劳组及观察组,比较2组血清炎症因子CRP、IL-6及可溶性肿瘤坏死因子受体2(sTNFR2)的差异;检测每位患者的疲劳相关炎症因子编码基因启动子的单核苷酸多态性,分析炎症因子相关基因分型与放射治疗结束时疲劳评分的相关性。结果共61例患者入组,其中疲劳组37例。观察组24例,癌性疲劳的发生率为60.6%。疲劳组伴有恶心、焦虑及厌食者较观察组多(P均<0.05)。疲劳组放射治疗后血清IL-6水平较治疗前高(P<0.001),观察组放射治疗前、后IL-6水平比较差异无统计学意义(P>0.05)。IL-6水平与疲劳的发生呈正相关(r_(s)=0.51,P<0.001)。2组治疗前后CRP及sTNFR2水平比较差异均无统计学意义(P均>0.05)。IL-6启动子编码基因IL6-174 GG基因分型的乳腺癌患者放射治疗结束时的疲劳评分高于CC基因分型患者(P=0.001)。结论血清IL-6水平及IL6-174 GG基因分型或与乳腺癌辅助放射治疗期间癌性疲劳的产生有关。Objective To investigate the correlation between inflammatory cytokines and cancerrelated fatigue(CRF)in breast cancer patients undergoing adjuvant radiotherapy.Methods Breast cancer patients receiving postoperative adjuvant radiotherapy were recruited and divided into the fatigue group and observation group according to the fatigue score of Edmonton Symptom Assessment System.The differences of serum inflammatory cytokines of CRP,IL-6 and soluble tumor necrosis factor receptor-2(sTNFR2)were statistically compared between two groups.The single nucleotide polymorphism of the genes encoding the inflammatory cytokines that were linked to CRF were also detected in each patient,and the relationship between genotyping and fatigue score was analyzed.Results Sixty one patients were enrolled,including 37 patients in the fatigue group and 24 cases in the control group.The incidence of CRF was 60.6%.The number of patients presenting with nausea,anxiety and lack of appetite in the fatigue group was significantly higher than that in the control group(all P<0.05).The serum concentration of IL-6 in the fatigue group was significantly increasedafter adjuvant radiotherapy(P<0.001),whereas the serum levels of IL-6 did not significantly differ before and after adjuvant radiotherapy in the control group(P>0.05).The serum level of IL-6 was positively correlated with the incidence of fatigue(r_(s)=0.51,P<0.001).The serum levels of CRP and sTNFR2 before and after corresponding treatment did not significantly differ between two groups(all P>0.05).Patients with GG genotyping of IL6-174 gene obtained significantly higher fatigue scores after radiotherapy compared with their counterparts with CC genotyping(P=0.001).Conclusion Serum IL-6 concentration and GG genotyping of IL6-174 gene are associated with the incidence of CRF in breast cancer patients during adjuvant radiotherapy.

关 键 词：炎症因子 癌性疲劳 白介素-6 IL6-174基因 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]