调强放疗联合化疗对晚期非小细胞肺癌血清三种因子表达变化的队列研究  

Cohort study of changes in expression of three serum cytokines in patients with advanced non-small cell lung cancer after intensity-modulated radiotherapy combined with chemotherapy

作　　者：田含含 周锡垒[1] 陈炜[1] 于长华[1] Tian Hanhan;Zhou Xilei;Chen Wei;Yu Changhua(Department of Radiotherapy,Affiliated Huaian First People's Hospital,Nanjing Medical University,Huaian 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院放疗科,223300

出　　处：《中华放射肿瘤学杂志》2021年第10期1007-1012,共6页Chinese Journal of Radiation Oncology

基　　金：淮安市自然科学研究计划(HAB201928)。

摘　　要：目的探究调强放疗联合化疗对晚期非小细胞肺癌(NSCLC)患者血清细胞增殖抗原(PCNA)、肿瘤特异性生长因子(TSGF)、可溶性E-钙黏蛋白(SE-CAD)表达变化及与预后的关系。方法选取2016—2018年南京医科大学附属淮安第一医院收治的晚期NSCLC患者84例(ⅢA、ⅢB、Ⅳ期分别为29、30、25例),均给予调强放疗联合化疗。检测对比不同TNM分期、治疗前后血清PCNA、TSGF、SE-CAD水平,并比较不同疗效患者血清PCNA、TSGF、SE-CAD水平。采用Logistic法分析血清PCNA、TSGF、SE-CAD水平与疗效关系。Kaplan-Meier法生存分析。结果Ⅳ期患者疗前血清PCNA、TSGF、SE-CAD水平高于ⅢB和ⅢA期[(584.11±60.25)pg/ml∶(531.06±51.37)pg/ml和(477.54±46.49)pg/ml、(96.13±7.54)U/ml∶(88.52±5.91)U/ml和(82.41±5.0)U/ml、(3.02±0.26)ng/ml∶(2.87±0.22)ng/ml和(2.71±0.15)ng/ml,均P<0.05],ⅢB期高于ⅢA期(均P<0.05)。疗后血清PCNA、TSGF、SE-CAD水平低于疗前水平[(396.11±50.23)pg/ml∶(528.37±75.09)pg/ml、(74.81±4.72)U/ml∶(88.68±6.13)U/ml、(1.92±0.24)ng/ml∶(2.86±0.31)ng/ml,均P<0.05]。疗后18个月生存患者PCNA、TSGF、SE-CAD水平低于死亡患者[(332.51±54.32)pg/ml∶(444.92±60.07)pg/ml、(70.59±6.20)U/ml∶(78.05±8.44)U/ml、(1.71±0.24)ng/ml∶(2.08±0.27)ng/ml,均P<0.05]。血清PCNA、TSGF、SE-CAD水平与预后显著相关(均P<0.05)。84例NSCLC患者疗后客观缓解率为29%(24/84)。疗后血清血清PCNA、TSGF、SE-CAD高表达组生存曲线低于低表达组(均P<0.05)。结论血清PCNA、TSGF、SE-CAD水平在晚期NSCLC患者中呈高表达,与临床分期、预后密切相关,且有助于预测生存状况。Objective To investigate the changes of the expression levels of serum proliferating cell nuclear antigen(PCNA),tumor-specific growth factor(TSGF),soluble E-cadherin(SE-CAD)and the relationship with clinical prognosis of advanced non-small cell lung cancer(NSCLC)patients treated with intensity-modulated radiotherapy combined with chemotherapy.Methods Eighty-four patients(29 cases ofⅢA,30ⅢB and 25Ⅳ)with advanced NSCLC treated in our hospital from January 2016 to January 2018 were selected,and all patients were given with intensity-modulated radiotherapy combined with chemotherapy.The expression levels of serum PCNA,TSGF,and SE-CAD were compared among different TNM stages and before and after treatment.The serum PCNA,TSGF,SE-CAD levels were compared among patients with different clinical efficacy.The relationship between serum PCNA,TSGF and SE-CAD levels and clinical efficacy was assessed by Logistic regression analysis.The survival analysis was performed with Kaplan-Meier method.Results The expression levels of serum PCNA,TSGF and SE-CAD before treatment in stageⅣpatients were significantly higher than those in stageⅢB andⅢA patients(584.11±60.25 pg/ml vs.531.06±51.37 pg/ml and 477.54±46.49 pg/ml,96.13±7.54 U/ml vs.8.52±5.91 U/ml and 82.41±5.0 U/ml,3.02±0.26 ng/ml vs.2.87±0.22 ng/ml and 2.71±0.15 ng/ml,all P<0.05),and the serum levels of three cytokines inⅢB stage patients were significantly higher than those in theirⅢA stage counterparts(all P<0.05).After treatment,the serum levels of PCNA,TSGF and SE-CAD were significantly lower than those before treatment(396.11±50.23 pg/ml vs.528.37±75.09 pg/ml,74.81±4.72 U/ml vs.88.68±6.13 U/ml,1.92±0.24 ng/ml vs.2.86±0.31 ng/ml,all P<0.05).At 18 months after treatment,the serum levels of PCNA,TSGF and SE-CAD in surviving patients were significantly lower than those of dead patients(332.51±54.32 pg/ml vs.444.92±60.07 pg/ml,70.59±6.20 U/ml vs.78.05±8.44 U/ml,1.71±0.24 ng/ml vs.2.08±0.27 ng/ml,all P<0.05).The serum levels of PCNA,TSGF and SE

关 键 词：癌 非小细胞肺/调强放射疗法 癌 非小细胞肺/化学疗法 细胞增殖抗原 肿瘤特异性生长因子 可溶性E-钙黏蛋白 

分 类 号：R734.2[医药卫生—肿瘤]