血细胞因子在肺癌分型及预后中的临床意义  

Role of peripheral cytokines in lung cancer pathological typing and prognosis

作　　者：许琼 马硝惟 刘斌[1] 蒋捍东[1] 吴学玲[1] Xu Qiong;Ma Xiaowei;Liu Bin;Jiang Handong;Wu Xueling(Department of Respiratory,Shanghai Jiaotong University School of Medicine,Renji Hospital,Shanghai 201112,China;Clinical laboratory,Shanghai Jiaotong University School of Medicine,Renji Hospital,Shanghai 201112,China)

机构地区：[1]上海交通大学医学院附属仁济医院呼吸科,上海201112 [2]上海交通大学医学院附属仁济医院检验科,上海201112

出　　处：《中华肺部疾病杂志（电子版）》2021年第3期283-287,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：上海交大医学院附属仁济医院临床创新课题(2019NYLYCP0103)。

摘　　要：目的探讨细胞因子在肺癌不同病理类型和预后判断中的意义。方法收集就诊于上海交通大学附属仁济医院的127例肺癌患者以及11例支气管哮喘、68例社区获得性肺炎患者的临床数据,包括病理类型、生存时间、临床分期、年龄等,同时收集这些患者多次入院病程中外周血细胞因子和肺癌相关肿瘤指标的实验室检查资料。统计分析细胞因子在肺癌、支气管哮喘和社区获得性肺炎中的表达差异。筛选出肺癌患者中升高的细胞因子,并统计分析它与肺癌分期、病理类型及预后的相关性。结果IL-6在肺癌患者中的水平明显高于支气管哮喘和社区获得性肺炎组(P<0.001),而其它的细胞因子在这三种疾病中的表达无明显差异。IL-6在肺鳞癌患者中升高最为明显;IL-6水平的高低与临床TNM分期相关,在Ⅲ、Ⅳ期肺癌患者中最高(P<0.05)。在肺癌的死亡患者中,血IL-6的水平随疾病的进展逐步升高,相关回归分析具有统计学差异(P<0.01)。生存分析显示IL-6高水平组的生存时间短于IL-6低水平组,风险比为3.04(P<0.05)。结论IL-6与肺癌患者病情进展及预后相关。Objective To investigate the effectiveness of cytokines as pathological and prognostic markers for lung cancer.Methods Peripheral levels of cytokines and lung cancer related tumor markers during multiple hospitalization,as well as clinical data,including pathological type,survival time,clinical stage and age,were collected in a retrospective cohort with 127 lung cancer patients,11 asthma and 68 pneumonia patients.All patients were admitted to Renji hospital,Shanghai Jiao Tong University School of Medicine.To identify new markers for lung cancer diagnostics,levels of cytokines were compared between lung cancer,asthma and pneumonia patients with statistical tests.The dynamics of significant cytokines were further evaluated among disease stages and during disease progression.Results The cytokine IL-6 levels were significantly higher in lung cancer compared to that in asthma and pneumonia patients(P<0.001).However,the level of other cytokines were not statistically different among these three groups.Furthur analysis showed that IL-6 levels were related to pathological type with highest level in squamous lung cancer.IL-6 levels were also associated with TNM stage,and were higher inⅢ-Ⅳstages(P<0.05).It was significantly increased with disease progression in patients who died of lung cancer(P<0.01).For individuals with high levels of IL-6,poorer overall survival was observed compared to those with lower levels of this cytokine(hazard ratio=3.04,P<0.05).Conclusion Peripheral IL-6 level is an effective marker for lung cancer progression and prognostic analysis.

关 键 词：支气管肺癌 白介素6 病理分型 预后 

分 类 号：R563[医药卫生—呼吸系统]