头颈部肿瘤患者放疗特征及放疗前免疫功能、炎症指标水平对放射性皮炎发生风险的影响  

Effects of radiotherapy characteristics,pre-radiotherapy immune function and levels of inflammatory indicators in patients with head and neck tumors on occurrence risk of radiation dermatitis

作　　者：岳雯[1] 桑娟[1] 朱成斌[1] YUE Wen;SANG Juan;ZHU Chengbin(Radiotherapy Center,Xinjiang Uygur Autonomous Region People′s Hospital,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院放疗中心,新疆乌鲁木齐830001

出　　处：《检验医学与临床》2025年第2期216-222,共7页Laboratory Medicine and Clinic

基　　金：新疆维吾尔自治区自然科学基金资助项目(2020D01C403)。

摘　　要：目的探讨头颈部肿瘤患者放疗特征及放疗前免疫功能、炎症指标水平对放射性皮炎发生风险的影响。方法以2020年1月至2023年12月于该院接受放疗的272例头颈部肿瘤患者作为研究对象。根据放疗期间是否发生放射性皮炎,将发生放射性皮炎的患者纳入研究组,未发生放射性皮炎的患者纳入对照组。根据放射性皮炎的严重程度将研究组患者分为轻度放射性皮炎组、重度放射性皮炎组。比较研究组与对照组一般临床资料、放疗相关特征及放疗前免疫功能(CD3^(+)T细胞比例、CD4^(+)T细胞比例、CD8^(+)T细胞比例、CD4^(+)T细胞/CD8^(+)T细胞比值)及炎症指标[白细胞介素(IL)-1β、IL-6、IL-8、肿瘤坏死因子(TNF-α)]水平。比较轻度放射性皮炎组、重度放射性皮炎组放疗相关特征及放疗前免疫功能和炎症指标水平。通过多因素Logistic回归分析头颈部肿瘤患者发生放射性皮炎的影响因素;绘制受试者工作特征(ROC)曲线评价各影响因素对头颈部肿瘤患者放疗后发生放射性皮炎的预测价值。结果研究组172例,对照组100例。研究组中101例划分为轻度放射性皮炎组,71例划分为重度放射性皮炎组。研究组与对照组间放疗形式、照射野数量、放疗次数比较,差异均无统计学意义(P>0.05);研究组患者放疗剂量大于对照组(P<0.05)。重度放射性皮炎组三维适形放疗比例、放疗剂量均大于轻度放射性皮炎组(P<0.05)。研究组与对照组间CD3^(+)、CD8^(+)T细胞比例比较,差异均无统计学意义(P>0.05);研究组CD4^(+)T细胞比例、CD4^(+)T细胞/CD8^(+)T细胞比值均低于对照组(P<0.05)。重度放射性皮炎组CD4^(+)T细胞比例、CD4^(+)T细胞/CD8^(+)T细胞比值均低于轻度放射性皮炎组(P<0.05),CD8^(+)T细胞比例高于轻度放射性皮炎组(P<0.05)。研究组与对照组间血清IL-6、IL-8、TNF-α水平比较,差异均无统计学意义(P>0.05);研究组血清IL-1β水平高�Objective To explore the radiotherapy characteristics,pre-radiotherapy immune function and inflammatory indicators levels in the patients with head and neck tumors and their impact on the occurrence risk of radiation dermatitis.Methods A total of 272 patients with head and neck tumors receiving radiotherapy in this hospital from January 2020 to December 2023 were selected as the research subjects.According to whether radiation dermatitis occurred during radiotherapy,the patients with radiation dermatitis were included in the study group,and those without radiation dermatitis were included in the control group.According to the severity of radiation dermatitis,the patients in the study group were divided into the mild radiation dermatitis group and severe radiation dermatitis group.The general clinical data,radiotherapy-related characteristics,pre-radiotherapy immune functions(proportion of CD3^(+)T cell,proportion of CD4^(+)T cell,proportion of CD8^(+)T cell,ratio of CD4^(+)T cell to CD8^(+)T cell)and inflammatory indicators[interleukin(IL)-1β,IL-6,IL-8,tumor necrosis factor(TNF-α)]levels were compared between the study group and control group.The radiotherapy-related characteristics,pre-radiotherapy immune functions and inflammatory indicator levels were compared between the mild radiation dermatitis group and severe radiation dermatitis group.The multivariate Logistic regression was used to analyze the influencing factors of radiation dermatitis occurrence in the patients with head and neck tumors;the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of each influencing factor for radiation dermatitis occurrence in the patients with head and neck tumors after radiotherapy.Results There were 172 cases in the study group and 100 cases in the control group.In the study group,101 cases were classified into the mild radiation dermatitis group and 71 cases were classified into the severe radiation dermatitis group.There were no statistically significant differences in radiotherap

关 键 词：头颈部肿瘤 放射性皮炎 免疫功能 危险因素 白细胞介素 

分 类 号：R739.91[医药卫生—肿瘤] R446.1[医药卫生—临床医学]