乳腺癌患者紫杉类药物治疗所致神经病理性疼痛与血清IL-6水平的相关性研究  

A study on the correlation between serum level of IL-6 and neuropathic pain caused by the treatment of taxanes in breast cancer patients

作　　者：刘淑娟 刘梦莹 陈一涛 苏乌云[3] 曹冉华[3] 常丽娟 窦佳 王薇[3] LIU Shu-juan;LIU Meng-ying;CHEN Yi-tao(The First School of Clinical Medicine,Inner Mongolia Medical University,Hohhot 010059,China;Department of Internal Medicine,Inner Mongolia A Rong Qi People′s Hospital,Hulun Buir 162750,China)

机构地区：[1]内蒙古医科大学第一临床医学院,呼和浩特010059 [2]内蒙古阿荣旗人民医院内科,呼伦贝尔162750 [3]内蒙古医科大学附属医院肿瘤内科,呼和浩特010050

出　　处：《中国临床新医学》2022年第11期1012-1016,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：北京科创医学发展基金会课题研究项目(编号:KC2021-JX-0044-9);2022年度内蒙古自治区卫生健康科技计划项目(编号:202202191)。

摘　　要：目的研究乳腺癌患者紫杉类药物治疗所致神经病理性疼痛与血清白细胞介素-6(IL-6)水平的相关性。方法回顾性分析2021年1月至2022年9月于内蒙古医科大学附属医院接受紫杉类药物治疗的24例乳腺癌患者的临床资料。检测患者化疗前血清IL-6的水平,应用疼痛视觉模拟量表(VAS)评估患者化疗4周期后神经病理性疼痛程度。根据药物所致的神经病理性疼痛程度分为A组(无痛9例)、B组(轻度疼痛6例)、C组(中度疼痛5例)和D组(重度疼痛4例),比较各组患者化疗前血清IL-6水平,分析其与VAS评分的相关性。绘制受试者工作特征(ROC)曲线分析血清IL-6对神经病理性疼痛的预测价值。结果随访4周期后,共15例患者出现神经病理性疼痛,四组患者的治疗前血清IL-6水平比较差异有统计学意义(P<0.01)。治疗前血清IL-6水平高于正常者更容易发生神经痛(P<0.05)。发生疼痛患者的血清IL-6水平与VAS评分呈正相关(r=0.855,P<0.01)。ROC曲线分析结果显示,治疗前血清IL-6水平能有效预测紫杉类药物治疗乳腺癌所致神经病理性疼痛(AUC=0.881,P=0.002)。结论患者化疗前血清IL-6水平与化疗所致神经痛程度呈正相关,化疗前血清IL-6水平可作为预测紫杉类药物治疗乳腺癌所致神经病理性疼痛的血清学指标。Objective To study the correlation between serum level of interleukin-6(IL-6)and neuropathic pain caused by the treatment of taxanes in breast cancer patients.Methods The clinical data of 24 breast cancer patients who were treated with taxanes in the Affiliated Hospital of Inner Mongolia Medical University from January 2021 to September 2022 were retrospectively analyzed.The level of IL-6 in the serum was detected before chemotherapy,and the degree of neuropathic pain after 4 cycles of chemotherapy was evaluated by Visual Analogue Scale(VAS)score.According to the degrees of drug-induced neuropathic pain,the patients were divided into group A(no pain,9 cases),group B(mild pain,6 cases),group C(moderate pain,5 cases)and group D(severe pain,4 cases).The level of IL-6 in the serum before chemotherapy was compared among all groups,and the correlation between the IL-6 level and the VAS scores was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of IL-6 in the serum for neuropathic pain.Results After 4 cycles of follow-up,15 patients developed neuropathic pain.There was a significant difference in the level of IL-6 among the four groups before treatment(P<0.01).The patients with higher IL-6 level than the normal IL-6 level before treatment were more likely to develop neuralgia(P<0.05).The level of IL-6 in the patients with pain was positively correlated with the VAS scores(r=0.855,P<0.01).The results of ROC curve analysis showed that the serum level of IL-6 before treatment could predict the neuropathic pain caused by the treatment of taxanes for breast cancer[area under the curve(AUC)=0.881,P=0.002].Conclusion The serum level of IL-6 in patients before chemotherapy is positively correlated with the degree of chemotherapy-induced neuralgia.The serum level of IL-6 before chemotherapy can be used as a serological indicator to predict the neuropathic pain caused by the treatment of taxanes for breast cancer.

关 键 词：乳腺癌 紫杉类药物 白细胞介素-6 神经病理性疼痛 

分 类 号：R737.9[医药卫生—肿瘤]