中性粒细胞与淋巴细胞比值、白细胞介素-17A及转化生长因子-β对局部晚期非小细胞肺癌患者发生放射性肺炎的诊断价值  

Diagnostic value of neutrophil-to-lymphocyte ratio,interleukin 17A and A transforming growth factorβfor radiation pneumonitis in patients with locally advanced non-small cell lung cancer

作　　者：刘维鹏 朱青山[1] 冯连杰[1] 张庆富[1] 付小娜 LIU Weipeng;ZHU Qingshan;FENG Lianjie;ZHANG Qingfu;FU Xiaona(Department of Radiotherapy,Anyang Cancer Hospital,Anyang 455000,He’nan,China)

机构地区：[1]安阳市肿瘤医院放疗科,河南安阳4550000

出　　处：《癌症进展》2022年第3期282-285,共4页Oncology Progress

摘　　要：目的探讨局部晚期非小细胞肺癌(NSCLC)患者放疗前后中性粒细胞与淋巴细胞比值(NLR)、白细胞介素-17A(IL-17A)、转化生长因子-β(TGF-β)水平及其对放射性肺炎的诊断价值。方法根据是否发生放射性肺炎将147例接受放疗的局部晚期NSCLC患者分为观察组(n=67,发生放射性肺炎)和对照组(n=80,未发生放射性肺炎)。比较放疗前、放疗结束后两组患者的外周血NLR及血清IL-17A、TGF-β水平,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),分析外周血NLR和血清IL-17A单独及联合检测对放射性肺炎的诊断价值。结果放疗前,两组患者的外周血NLR及血清IL-17A、TGF-β水平比较,差异均无统计学意义(P﹥0.05)。放疗结束后,观察组患者的外周血NLR和血清IL-17A水平均明显高于对照组,差异均有统计学意义(P﹤0.01);放疗结束后,两组患者的血清TGF-β水平比较,差异无统计学意义(P﹥0.05)。放疗结束后,两组患者的外周血NLR和血清IL-17A水平均高于本组放疗前,血清TGF-β水平均低于本组放疗前,差异均有统计学意义(P﹤0.05)。外周血NLR诊断放射性肺炎的灵敏度为60.00%,特异度为72.50%,AUC为0.715;血清IL-17A诊断放射性肺炎的灵敏度为75.00%,特异度为85.00%,AUC为0.859;NLR联合IL-17A诊断放射性肺炎的灵敏度为83.75%,特异度为88.81%,AUC为0.919。结论发生放射性肺炎的局部晚期NSCLC患者的外周血NLR和血清IL-17A水平均较未发生放射性肺炎的患者显著升高,二者联合检测对放射性肺炎具有较高的诊断价值。Objective To investigate the levels of neutrophil-to-lymphocyte ratio(NLR),interleukin-17A(IL-17A),and transforming growth factor-β(TGF-β)in patients with locally advanced non-small cell lung cancer(NSCLC)before and after the radiotherapy and its diagnostic value for radiation pneumonitis.Method A total of 147 patients with locally advanced NSCLC who received radiotherapy were divided into observation group(n=67,with radiation pneumonitis)and control group(n=80,without radiation pneumonitis)according to whether radiation pneumonitis occurred.The peripheral blood NLR and serum IL-17A and TGF-βlevels of patients in the two groups before and after radiotherapy were com-pared,the receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated.The diagnostic value of peripheral blood NLR and serum IL 17A alone and in combination for radiation pneumonitis were also analyzed.Result Before the radiotherapy,there was no significant difference in peripheral blood NLR and se-rum IL-17A and TGF-βlevels between the two groups(P>0.05).After the radiotherapy,the levels of peripheral blood NLR and serum IL-17A in the observation group were significantly higher than those in the control group,and the differ-ences were statistically significant(P<0.01).After the radiotherapy,there was no statistically significant difference in the serum TGF-βlevels between the two groups(P>0.05).After the radiotherapy,the levels of peripheral blood NLR and se-rum IL-17A in the two groups were higher than those before radiotherapy,and the serum TGF-βlevels were lower than those before radiotherapy,and the differences were statistically significant(P<0.05).The sensitivity of peripheral blood NLR in the diagnosis of radiation pneumonia was 60.00%,the specificity was 72.50%,and the AUC was 0.715;the sensi-tivity of serum IL-17A in the diagnosis of radiation pneumonia was 75.00%,the specificity was 85.00%,and the AUC was 0.859;when combined with NLR and IL-17A,the sensitivity of diagnosing radiation pneumonit

关 键 词：中性粒细胞 淋巴细胞 非小细胞肺癌 白细胞介素-17A 转化生长因子-Β 放射性肺炎 

分 类 号：R734.2[医药卫生—肿瘤]