血清CD4+/CD8+、PCT及KL-6水平与局部晚期NSCLC放疗后放射性肺炎严重程度的相关性研究  

Study on the association between the levels of Serum CD4+/CD8+, PCT, KL-6 and severity of Radiation Pneumonitis after Radiotherapy for Locally Advanced NSCLC

作　　者：崔晶娴 董业峰 陈烨 黄霞 刘颖 葛仁美 CUI Jingxian;DONG Yefeng;CHEN Ye;HUANG Xia;LIU Ying;GE Renmei(Department of laboratory,Hai'an people's Hospital,Jiangsu Province,Hai'an Jiangsu 226600,China)

机构地区：[1]海安市人民医院检验科,江苏海安226600

出　　处：《转化医学杂志》2022年第6期384-387,共4页Translational Medicine Journal

基　　金：南通市卫计委青年医学人才科研基金(WKZD2018025)。

摘　　要：目的 研究血清分化决定族抗原4+/分化决定族抗原8+(CD4+/CD8+)、降钙素原(PCT)及涎液化糖链抗原(KL-6)水平与局部晚期非小细胞肺癌(NSCLC)放疗后重症放射性肺炎相关性。方法 选取2019年5月至2021年3月海安市人民医院收治的103例局部晚期NSCLC患者,根据放疗后放射性肺炎评估结果分组:未发生放射性肺炎作为对照组,共54例;发生放射性肺炎且分级在1~2级作为轻症组,共31例;分级≥3级患者作为重症组,共18例。分别于放疗前后检测3组血清CD4+/CD8+、PCT及KL-6水平,采用Logistic回归模型分析重症放射性肺炎影响因素。结果 单因素分析发现,三组放疗前KPS评分、FEV1/FVC、照射剂量<60Gy比例、放疗后CD4+/CD8+、放疗后PCT、放疗后KL-6比较,差异具有统计学意义(P<0.05)。其中重症组放疗前KPS评分、FEV1/FVC、照射剂量<60Gy比例及放疗后CD4+/CD8+低于对照组与轻症组,且轻症组放疗前KPS评分、FEV1/FVC、照射剂量<60Gy比例及放疗后CD4+/CD8+低于对照组。而重症组放疗后PCT、放疗后KL-6高于对照组与轻症组,且轻症组放疗后PCT,放疗后KL-6高于对照组(P<0.05)。Logistic回归分析显示,放疗后血清CD4+/CD8+下降、PCT、KL-6水平升高、照射剂量≥60Gy为重症放射性肺炎的独立危险因素(P<0.05)。结论 放疗结束后局部晚期NSCLC患者血清CD4+/CD8+下降,PCT、KL-6水平上升,照射剂量≥60Gy对预测重症放射性肺炎发生具有重要价值。Objective To investigate the relationship between serum levels of cluster of Differentiation 4+/cluster of Differentiation 8+(CD4+/CD8+), procalcitonin(PCT), salivary glycochain antigen(KL-6), and severe radiation pneumonia after radiotherapy for locally advanced non-small cell lung cancer(NSCLC). Methods A total of 103 patients with locally advanced NSCLC admitted to the People’s Hospital of Hai’an City from May 2019 to March 2021were selected and divided into 3 groups according to the evaluation results of radiation pneumonia after radiotherapy. Patients without radiation pneumonia were classified as congrol group with 54 cases in it. There 31 patients with grade 1~2of radiation pneumonia were classified as mild disease group and 18 patients with grade 3 or higher of radiation pneumonia were classified as critical group. Serum CD4+/CD8+,PCT, and KL-6 levels of the 3 groups were detected before and after radiotherapy. The influencing factors of severe radiation pneumonia were analyzed by Logistic regression model.Results Univariate analysis showed that KPS score before radiotherapy, FEV1/FVC, proportion of irradiation dose<60Gy, CD4+/CD8+after radiotherapy, PCT after radiotherapy, and KL-6 after radiotherapy were significantly different among the three groups(P<0.05). KPS score before radiotherapy, FEV1/FVC, proportion of radiation dose<60Gy, and CD4+/CD8+ after radiotherapy in severe group were lower than those in the control group and mild group. KPS score before radiotherapy, FEV1/FVC, proportion of radiation dose<60Gy, and CD4 +/CD8 + after radiotherapy in the mild group were lower than those in the control group. The PCT and KL-6 after radiotherapy in the severe group were higher than those in the control group and mild group. And the PCT and KL-6 after radiotherapy in the mild group were higher than those in the control group(P<0.05). Logistic analysis showed that after radiotherapy, decrease of serum CD4 +/CD8+, increase of serum PCT and KL-6, and radiation dose above 60Gy were independent risk factor

关 键 词：非小细胞肺癌 放射性肺炎 CD4+/CD8+ 降钙素原 涎液化糖链抗原 

分 类 号：R734.2[医药卫生—肿瘤]