局部进展期肺癌患者同步加量调强放疗后血清鳞状细胞癌抗原和基质金属蛋白酶的表达及临床意义  

Changes of serum squamous cell carcinoma antigen and matrix metalloproteinase level in patients with locally advanced lung cancer after simultaneous intensive modulated radiotherapy and their clinical significance

作　　者：汪关雨 陈建兵 宋鹏慧 WANG Guanyu;CHEN Jianbing;SONG Penghui(Department of Radiotherapy,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院放射治疗科,山西长治046000

出　　处：《临床肿瘤学杂志》2024年第5期446-451,共6页Chinese Clinical Oncology

摘　　要：目的探讨局部进展期肺癌患者同步加量调强放疗(SIB-IMRT)后血清鳞状细胞癌抗原(SCC-Ag)和基质金属蛋白酶(MMP)-2、MMP-9水平的变化及临床意义。方法收集2018年4月至2021年3月长治医学院附属和平医院收治的148例原发性肺癌患者,采用酶联免疫吸附法检测患者入院时和放疗1个月后血清SCC-Ag、MMP-2和MMP-9水平。随访患者的总生存期(OS)、无进展生存期(PFS)、毒副反应和总有效率(ORR)。结果全组患者均评估疗效,获完全缓解(CR)16例,部分缓解(PR)63例,疾病稳定(SD)57例,疾病进展(PD)12例,ORR为53.38%(79/148)。110例患者发生急性放射性食管炎,其中27例为3级;39例患者发生急性放射性肺炎,其中14例为3级或以上。放疗前有效(CR+PR)组血清SCC-Ag水平略低于无效(SD+PD)组,差异有统计学意义(P=0.037),放疗1个月后,两组血清SCC-Ag、MMP-2、MMP-9水平都有所降低(P<0.05),但是有效组降低更显著(P<0.001)。多因素Cox回归分析显示,放疗前SCC-Ag水平是OS、PFS的独立预测因素,放疗后SCC-Ag水平和MMP-9水平为OS的独立预测因素。放疗前SCC-Ag水平<7.60μg/L的患者中位OS较放疗前SCC-Ag水平≥7.60μg/L的患者长;放疗后SCC-Ag水平<1.40μg/L的患者中位PFS较放疗前SCC-Ag水平≥1.40μg/L的患者长;放疗后MMP-2水平<23.81μg/L的患者中位OS较放疗后MMP-2水平≥23.81μg/L的患者长;放疗后MMP-9水平<74.70μg/L的患者中位OS较放疗后MMP-9水平≥74.70μg/L的患者长。结论血清SCC-Ag、MMP-2、MMP-9水平对肺癌患者放疗后的预后具有一定的预测价值,尤其是放疗前SCC-Ag水平。Objective To investigate the level of serum squamous cell carcinoma antigen(SCC-Ag)and metalloproteinase in patients with locally advanced lung cancer after simultaneous intensive modulated radiotherapy(SIB-IMRT)clinical significance.Methods The chinical data of 148 patients with primary lung cancer was colledcted from April 2018 to March 2021 in the Peace Hospital Affiliated to Changzhi Medical College.Serum levels of SCC-Ag,MMP-2 and MMP-9 were measured by ELISA in 148 patients at admission and one month after radiotherapy.Overall survival(OS),progression-free survival(PFS),toxicity and total response rate(ORR)were followed up.Results The efficacy of all patients was evaluated,with 16 cases achieving complete remission(CR),63 cases partial remission(PR),57 cases disease stability(SD),12 cases disease progression(PD),and an ORR of 53.38%(79/148).Acute radiation esophagitis occurred in 110 patients,27 of whom were grade 3.Acute radiation-induced pneumonia occurred in 39 patients,14 of whom had acute radiation-induced pneumonia before radiotherapy.Serum SCC-Ag levels in the effective group(CR+PR)were slightly lower than those in the ineffective group(SD+PD),and the difference was statistically significant(P=0.037).After one month of radiotherapy,serum SCC-Ag,MMP-2 and MMP-9 levels in both groups decreased(P<0.05),but the decrease was more significant in the effective group(P<0.001).Multivariate Cox analysis showed that the level of SCC-Ag before radiotherapy was an independent predictor of OS and PFS,and the level of SCC-Ag and MMP-9 after radiotherapy were independent predictors of OS.The median OS in patients with SCC-Ag levels<7.60μg/L before radiotherapy was longer than that in patients with SCC-Ag≥7.60μg/L before radiotherapy.The median PFS of patients with SCC-Ag levels<1.40μg/L after radiotherapy was longer than that of patients with SCC-Ag levels≥1.40μg/L before radiotherapy.The median OS in patients with MMP-2 level<23.81μg/L after radiotherapy was longer than that in patients with MMP-2 level≥

关 键 词：肺癌 同步加量调强放疗 鳞状细胞癌抗原 基质金属蛋白酶-2 基质金属蛋白酶-9 预后 

分 类 号：R734.2[医药卫生—肿瘤]