血清sCD163、IFN-γ联合TGF-β1对NSCLC患者放疗后发生放射性肺炎的早期预测价值  

Early predictive value of serum sCD163,IFN-γcombined with TGF-β1 in the development of radiationinduced pneumonia in NSCLC patients

作　　者：黄波[1] 汪鹏[1] Huang Bo;Wang Peng(Department of Radiology,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,China)

机构地区：[1]武汉市中医医院放射科,武汉430014

出　　处：《国际肿瘤学杂志》2024年第9期563-568,共6页Journal of International Oncology

摘　　要：目的分析血清可溶性CD163分子(sCD163)、γ-干扰素(IFN-γ)联合转化生长因子-β1(TGF-β1)对非小细胞肺癌(NSCLC)患者放疗后发生放射性肺炎(RP)的早期预测价值。方法选择2020年12月至2023年11月武汉市中医医院收治的临床分期为Ⅲ~Ⅳ期接受放疗的NSCLC患者132例。采用酶联免疫吸附试验检测血清sCD163、IFN-γ、TGF-β1水平。分析患者放疗后RP发生情况,对接受放疗NSCLC患者发生RP与未发生RP患者以及不同级别RP患者血清sCD163、IFN-γ、TGF-β1水平进行比较。采用多因素logistic回归分析NSCLC患者发生RP的影响因素;采用受试者操作特征(ROC)曲线分析血清sCD163、IFN-γ联合TGF-β1对NSCLC放疗患者发生RP的预测价值。结果接受放疗NSCLC患者RP发生率为24.24%(32/132),其中Ⅱ级18例、Ⅲ级12例、Ⅳ级2例。RP患者血清sCD163[(94.30±15.78)pg/ml比(75.43±13.16)pg/ml,t=6.72,P<0.001]、IFN-γ[(6.52±1.54)pg/ml比(4.79±0.94)pg/ml,t=7.65,P<0.001]、TGF-β1[(9.40±2.63)μg/L比(6.30±1.55)μg/L,t=8.18,P<0.001]水平均显著高于无RP患者,差异均有统计学意义。且Ⅲ~Ⅳ级RP患者血清sCD163[(104.44±15.97)pg/ml比(86.41±15.63)pg/ml,t=3.21,P=0.003]、IFN-γ[(7.47±1.56)pg/ml比(5.78±1.52)pg/ml,t=3.09,P=0.004]、TGF-β1[(11.27±2.68)μg/L比(7.94±2.59)μg/L,t=3.55,P=0.001]水平均高于Ⅱ级RP患者,差异均有统计学意义。RP患者与无RP患者放射剂量(χ^(2)=9.25,P=0.002)、V20(t=6.39,P<0.001)、平均肺剂量(MLD)(t=3.57,P<0.001)差异均有统计学意义。多因素分析显示,放射剂量(OR=3.98,95%CI为2.22~7.15,P<0.001)、V20(OR=4.75,95%CI为2.03~11.15,P<0.001)、MLD(OR=3.15,95%CI为1.63~6.09,P=0.001)、sCD163(OR=4.53,95%CI为1.63~12.58,P=0.004)、IFN-γ(OR=5.11,95%CI为2.07~12.65,P<0.001)、TGF-β1(OR=5.55,95%CI为2.99~10.31,P<0.001)均是接受放疗NSCLC患者发生RP的独立影响因素。sCD163、IFN-γ、TGF-β1单独预测接受放疗NSCLC患者发生RP的ROC曲线下面积(AUC)分别为0.81(95%CI为0.72~0.89)、0.83(9Objective To analyze the early predictive value of serum soluble CD163(sCD163),interferon-γ(IFN-γ),and transforming growth factor-β1(TGF-β1)for radiation pneumonitis(RP)in nonsmall cell lung cancer(NSCLC)patients after radiation therapy.Methods One hundred and thirty-two NSCLC patients with clinical stageⅢ-Ⅳreceiving radiotherapy at Wuhan Hospital of Traditional Chinese Medicine from December 2020 to November 2023 were selected.Serum sCD163,IFN-γand TGF-β1 levels were detected by enzyme-linked immunosorbent assay.The occurrence of RP after radiotherapy was analyzed;serum sCD163,IFN-γ,and TGF-β1 levels were compared between NSCLC patients receiving radiotherapy who had RP and those who did not,as well as patients with different levels of RP.Multivariate logistic regression was used to analyze the factors affecting the occurrence of RP in NSCLC patients;the predictive value of serum sCD163,IFN-γcombined with TGF-β1 for the occurrence of RP in patients undergoing radiotherapy for NSCLC was analyzed using reciver operator characteristic(ROC)curves.Results The incidence of RP in NSCLC patients receiving radiotherapy was 24.24%(32/132).There were 18 cases of gradeⅡ,12 cases of gradeⅢ,2 cases of gradeⅣ.Serum sCD163 levels in patients with RP[(94.30±15.78)pg/ml vs.(75.43±13.16)pg/ml,t=6.72,P<0.001],IFN-γ[(6.52±1.54)pg/ml vs.(4.79±0.94)pg/ml,t=7.65,P<0.001],TGF-β1[(9.40±2.63)μg/L vs.(6.30±1.55)μg/L,t=8.18,P<0.001]were significantly higher than those of patients without RP,and there were statistically significant differences.And levels of serum sCD163[(104.44±15.97)pg/ml vs.(86.41±15.63)pg/ml,t=3.21,P=0.003],IFN-γ[(7.47±1.56)pg/ml vs.(5.78±1.52)pg/ml,t=3.09,P=0.004]and TGF-β1[(11.27±2.68)μg/L vs.(7.94±2.59)μg/L,t=3.55,P=0.001]in RP patients with gradeⅢ-Ⅳwere higher than those in RP patients with gradeⅡ,and there were statistically significant differences.There were statistically significant differences in radiation dose(χ^(2)=9.25,P=0.002),V20(t=6.39,P<0.001)and mean lung dose

关 键 词：癌 非小细胞肺 辐射性肺炎 可溶性CD163分子 Γ-干扰素 转化生长因子-β1 

分 类 号：R734.2[医药卫生—肿瘤]