血清细胞因子表达与食管癌放射性肺损伤的关联分析  

Correlation between serum HMGB1 and soluble receptor sRAGE changes and radiation-induced lung injury in patients with esophageal cancer

作　　者：汪毅 朱华庆[2] 王宇 许阳 刘思涵 葛磊 高俊峰 秦雷 李红霞 WANG Yi;ZHU Hua-qing;WANG Yu;XU Yang;LIU Si-han;GE Lei;GAO Jun-feng;QIN Lei;LI Hong-xia(Department of Oncology,Third Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Department of Biochemistry&Molecular Biology,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学第三附属医院肿瘤科,安徽合肥230601 [2]安徽医科大学生物化学与分子生物学教研室,安徽合肥230032

出　　处：《中华肿瘤防治杂志》2021年第17期1333-1338,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：合肥市卫健委应用医学研究重点项目(hwk2017zd013);安徽省省级引才引智重点项目(S20193400016)。

摘　　要：目的探讨接受放疗食管癌患者血清中高迁移率族蛋白B1(HMGB1)、糖基化终产物分泌型受体(sRAGE)、白细胞介素10(IL-10)和转化生长因子β(TGF-β)等细胞因子的变化情况,及其与放射性肺损伤(RILI)的关系。方法回顾性分析2016-02-29-2020-05-26安徽医科大学第三附属医院收治的首次行胸部根治性三维适行放疗的50例食管癌患者临床资料。选取患者放疗前,放疗20 Gy,放疗40 Gy,放疗结束,放疗开始后10、12和14周采集的外周血标本,使用酶联免疫吸附法(ELISA)检测患者血清中HMGB1、sRAGE、IL-10和TGF-β的表达。以单因素重复测量方差分析检验放疗前后所有患者细胞因子水平变化。将患者分为RILI组(n=9)和非RILI组(n=41),以两因素重复测量方差分析检验时间与分组因素对患者细胞因子水平变化的影响。细胞因子与RILI的关联性采用二分类Logistic多因素回归分析。结果患者外周血中的IL-10(F=1.935,P=0.075)、TGF-β(F=1.970,P=0.095)、HMGB1(F=1.391,P=0.224)和sRAGE(F=2.209,P=0.052)总体水平在放疗过程中无明显变化。RILI的发生以及时间因素对患者外周IL-10(F=1.781,P=0.123)和TGF-β(F=1.580,P=0.173)表达水平影响差异均无统计学意义,对HMGB1(F=5.391,P=0.049)和sRAGE(F=8.017,P=0.022)表达水平的影响差异均有统计学意义。在二分类Logistic多因素回归分析中,HMGB1(χ^(2)=6.881,P=0.009)和sRAGE(χ^(2)=8.516,P=0.004)的整体水平变化与RILI的发生存在相关性。结论血清HMGB1和sRAGE水平在放射性肺损伤发生中呈异常表达状态,并且与RILI的发生存在相关性。动态监测HMGB1和sRAGE的水平变化,有助于放射性肺损伤的病情判断及评估。Objective To investigate the relationship between serum high-mobility group box-1(HMGB1),soluble receptor for advanced glycation end products(sRAGE),interleukin 10(IL-10),transforming growth factor-beta(TGF-β) and radiation induced lung injury(RILI) in patients with esophageal cancer receiving radiotherapy. Methods A retrospective analysis of 50 cases of esophageal cancer who received radical thoracic three-dimensional radiotherapy for the first time in Third Affiliated Hospital of Anhui Medical University from February 29,2016 to May 26,2020 was conducted. Peripheral blood samples were collected from the patients before radiotherapy, 20 Gy, 40 Gy, the end of radiotherapy, and 10,12,14 weeks after radiotherapy. The expressions of HMGB1,sRAGE,IL-10 and TGF-β in serum of the patients were detected by enzyme linked immunosorbent assay(ELISA). The one-way repeated-measures ANOVA was used to compare the changes of cytokines in all patients before and after radiotherapy. Patients were divided into two groups according to the occurrence of RILI or not, and the effects of time and grouping factors on the change of cytokines were tested by two-way repeated-measures ANOVA. The correlation between cytokines and RILI was analyzed by two-category logistic multivariate regression.Results The overall levels of IL-10(F=1.935,P=0.075),TGF-β(F=1.970,P=0.095),HMGB1(F=1.391,P=0.224)and sRAGE(F=2.209,P=0.052)in the peripheral blood of patients did not change significantly during radiotherapy.The occurrence of RILI and treatment time had no effects on the levels of IL-10(F=1.781,P=0.123)and TGF-β(F=1.580,P=0.173)in all patients,but had statistically significant effects on the levels of HMGB1(F=5.391,P=0.049)and sRAGE(F=8.017,P=0.022).Two-category Logistic multivariate regression analysis showed that the changes of HMGB1(χ^(2)=6.881,P=0.009)and sRAGE(χ^(2)=8.516,P=0.004)were correlated with the occurrence of RILI.Conclusions Serum HMGB1 and sRAGE levels are abnormally expressed and correlated with the occurrence of RILI.Dynamic m

关 键 词：放射性肺损伤 高迁移率族蛋白B1 分泌型晚期糖化终产物受体 转化生长因子-β 白介素-10 

分 类 号：R735.1[医药卫生—肿瘤]