Nrf2与NF-κB对鼻咽癌患者放射性黏膜炎的交互作用及预测效能  

Interaction and predictive efficacy of nuclear factor erythroid 2-related factor 2(Nrf2)and nuclear factorκB(NF-κB)on radiation mucositis in patients with nasopharyngeal carcinoma

作　　者：杨卫林 王骁 顾培 潘德键 YANG Weilin;WANG Xiao;GU Pei;PAN Dejian(Department of Hematology and Oncology,the 904th Hospital of the Joint Logistics Support Force,Wuxi Jiangsu 214000,China;Department of Radiotherapy,Affiliated Tumor Hospital of Nantong University,Nantong Jiangsu 226000,China)

机构地区：[1]联勤保障部队第904医院血液肿瘤科,江苏无锡214000 [2]南通大学附属肿瘤医院放疗科,江苏南通226000

出　　处：《新疆医科大学学报》2024年第3期343-348,354,共7页Journal of Xinjiang Medical University

基　　金：江苏省卫生健康委员会科研项目(B201932)。

摘　　要：目的 探讨核转录因子红系2相关因子2(Nrf2)与核因子κB(NF-κB)对鼻咽癌患者放射性黏膜炎的交互作用及预测效能。方法 选取2021年8月至2023年2月联勤保障部队第904医院与南通大学附属肿瘤医院收治的116例鼻咽癌患者作为研究对象,所有患者均行放疗治疗,根据放疗第3周放射性黏膜炎发生情况分为无症状组(0级)、轻度组(1~2级)、重度组(3~4级)。对比3组患者血清Nrf2、NF-κB水平。Spearman秩相关系数分析血清Nrf2、NF-κB水平与发生放射性黏膜炎的相关性。受试者工作特征曲线(ROC曲线)分析血清Nrf2、NF-κB水平对重度放射性黏膜炎发生风险的预测价值。分析重度放射性黏膜炎发生的影响因素及Nrf2与NF-κB对重度放射性黏膜炎发生的交互作用。结果 重度组血清Nrf2水平低于轻度组、无症状组,血清NF-κB水平高于轻度组、无症状组,轻度组血清Nrf2水平低于无症状组,血清NF-κB水平高于无症状组(P<0.05);放疗前血清Nrf2水平与放射性黏膜炎发生呈低度负相关(r=-0.452,P<0.001),放疗1周血清Nrf2水平与放射性黏膜炎发生呈中度负相关(r=-0.586,P<0.001),放疗3周血清Nrf2水平与放射性黏膜炎发生呈中度负相关(r=-0.620,P<0.001);放疗前血清NF-κB水平与放射性黏膜炎发生呈低度正相关(r=0.475,P<0.001),放疗1周血清NF-κB水平与放射性黏膜炎发生呈中度正相关(r=0.541,P<0.001),放疗3周血清NF-κB水平与放射性黏膜炎发生呈中度正相关(r=0.619,P<0.001);预防性用药、放疗1周血清Nrf2水平是重度放射性黏膜炎发生的独立保护因素,吸烟史、放疗剂量、放疗1周血清NF-κB水平是重度放射性黏膜炎发生的独立危险因素(P<0.05);血清Nrf2、NF-κB水平联合预测重度放射性黏膜炎发生的AUC值为0.829,大于血清Nrf2(Z=2.519,P=0.012)、NF-κB(Z=2.084,P=0.037)水平单独预测的AUC值(分别为0.730、0.764)(P<0.05);Nrf2与NF-κB对重度放射性黏膜炎发生存在拮抗Objective To investigate the interaction and predictive efficacy of nuclear factor erythroid 2-re-lated factor 2(Nrf2)and nuclear factorκB(NF-κB)on radiation mucositis in patients with nasopharyngeal carcinoma.Methods A total of 116 patients with nasopharyngeal carcinoma in the hospital from August 2021 to February 2023 were selected,all of whom were treated with radiotherapy.According to the occur-rence of radioactive mucositis at the 3rd week of radiotherapy,the patients were divided into asymptomatic group(grade 0),mild group(grade 1-2)and severe group(grade 3-4).The levels of serum Nrf2 and NF-κB in 3 groups were compared.Spearman rank correlation coefficient was used to analyze the relation-ship between serum Nrf2,NF-κB levels and the incidence of radiation mucositis.Receiver operating char-acteristic curve(ROC curve)was used to analyze the predictive value of serum Nrf2 and NF-κB levels on the risk of severe radiation mucositis.The influencing factors of severe radiation mucositis and the interac-tion between Nrf2 and NF-κB on severe radiation mucositis were analyzed.Results Serum Nrf2 level in severe group was lower than that in mild group and asymptomatic group,serum NF-κB level was higher than that in mild group and asymptomatic group,serum Nrf2 level in mild group was lower than that in asymptomatic group,and serum NF-κB level was higher than that in asymptomatic group(P<0.05).There was a low negative correlation between serum Nrf2 level and the occurrence of radiation mucositis before radiotherapy(r=-0.452,P<0.001),and a moderate negative correlation between serum Nrf2 level and the occurrence of radiation mucositis after 1 week of radiotherapy(r=-0.586,P<0.001),and a moderate negative correlation between serum Nrf2 level and the occurrence of radiation mucositis after 3 weeks of radiotherapy(r=-0.620,P<0.001).There was a low positive correlation between serum NF-κB level and the incidence of radiation catarrh before radiotherapy(r=0.475,P<0.001),and a moderate positive correlation between ser

关 键 词：核转录因子红系2相关因子2 核因子ΚB 鼻咽癌 黏膜炎 

分 类 号：R762[医药卫生—耳鼻咽喉科]