鼻咽癌放疗后患者内毒素和可溶性白细胞介素2受体水平与化脓性中耳炎发生的相关性  

Correlation between endotoxin and sIL-2R levels and the occurrence of suppurative otitis media in patients with nasopharyngeal carcinoma after radiotherapy

作　　者：魏璐璐[1] 吉文伟 尹中普[1] 范栩嫚 陈子涵 WEI Lulu;JI Wenwei;YIN Zhongpu;FAN Xuman;CHEN Zihan(Department of Otolaryngology,Nanyang City Center Hospital,Nanyang,Henan,473005,China;Department of Minimally Invasive General Surgery,Nanyang Second People's Hospital,Nanyang,Henan,473000,China)

机构地区：[1]南阳市中心医院耳鼻咽喉科,河南南阳473005 [2]南阳市第二人民医院微创普外科,河南南阳473000

出　　处：《中国耳鼻咽喉头颈外科》2025年第1期8-12,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191456)。

摘　　要：目的探究鼻咽癌放疗后患者内毒素和可溶性白细胞介素2受体(soluble interleukin-2 receptor,sIL-2R)表达水平与化脓性中耳炎发生的相关性。方法回顾性分析2022年1月~2023年7月在南阳市中心医院接受放疗的79例鼻咽癌患者作为研究对象,对其进行为期1年的随访。根据随访期间化脓性中耳炎发生情况进行分组,其中发生组21例,未发生组58例,对比两组患者的基线资料,并在放疗结束时检测内毒素和sIL-2R表达水平,分析鼻咽癌放疗后内毒素、sIL-2R与化脓性中耳炎发生的关系。结果79例鼻咽癌患者放疗后共有21例(26.58%)发生化脓性中耳炎。与未发生组相比,发生组患者放疗时间、内毒素、sIL-2R、TNM分期Ⅲ期、咽鼓管受累、鼻腔结构异常、炎性反应、腭帆张肌萎缩程度≥30%均升高,差异有统计学意义(P均<0.05)。经Logistic多因素分析结果显示,炎性反应、内毒素、鼻腔结构异常、TNM分期Ⅲ期、sIL-2R、咽鼓管受累、放疗时间、腭帆张肌萎缩程度≥30%均属于化脓性中耳炎的风险因素。经Spearman秩相关分析结果显示,内毒素和sIL-2R与化脓性中耳炎发生呈正相关(r=0.493、0.516,P<0.001)。ROC曲线分析结果显示,内毒素:AUC值为0.657,敏感度为61.90%,特异度为72.41%,准确度为69.62%,95%CI=0.523~0.791;sIL-2R:AUC值为0.697,敏感度为71.43%,特异度为67.24%,准确度为68.35%,95%CI=0.566~0.829;联合检测:AUC值为0.804,敏感度为95.24%,特异度为65.52%,准确度为73.42%,95%CI=0.705~0.903,两项联合检测价值最佳。结论鼻咽癌放疗后患者内毒素和sIL-2R水平升高可能与化脓性中耳炎发生相关。OBJECTIVE To investigate the relationship between the expression level of endotoxin and soluble interleukin-2 receptor(sIL-2R)and the occurrence of suppurative otitis media in patients with nasopharyngeal carcinoma after radiotherapy.METHODS Seventy-nine nasopharyngeal cancer patients who received radiotherapy in Nanyang Downtown Hospital between January 2022 and July 2023 were selected as the study subjects,and they were followed up for a period of 1 year,and then grouped according to the occurrence of suppurative otitis media during the follow-up period,i.e.,21 cases in the occurringgroup and 58 cases in the non-occurring group,and the baseline data of patients in the two groups were compared,and the levels of endotoxin and sIL-2R were detected at the end of radiotherapy and analyze the relationship between endotoxin,sIL-2R and the occurrence of purulent otitis media after radiotherapy for nasopharyngeal carcinoma.RESULTS A total of 21 cases(26.58%)of 79 nasopharyngeal carcinoma patients developed suppurative otitis media after radiotherapy.Compared with the non-occurrence group,the radiotherapy time,endotoxin,sIL-2R,TNM stage III,Eustachian tube involvement,nasal cavity structural abnormality,inflammatory reaction,and palatal sail tensor atrophy degree≥30%were high in the occurrence group,and the difference was statistically significant(all P<0.05).The results of logistic multifactorial analysis showed that inflammatory reaction,endotoxin,abnormal nasal structure,TNM stage(III),sIL-2R,Eustachian tube involvement,duration of radiotherapy,and degree of atrophy of palatofacial tensor atrophy≥30%were all risk factors for suppurative otitis media.The results of Spearman's rank correlation analysis showed that endotoxin and sIL-2R were positively correlated with the occurrence of septic otitis media(r=0.493,0.516,P<0.001).Analysis using the ROC curve showed that:endotoxin:AUC value:0.657,sensitivity:61.90%,specificity:72.41%,accuracy:69.62%,95%CI=0.523-0.791;sIL-2R:AUC value:0.697,sensitivity:71.43%,specificity:

关 键 词：鼻咽肿瘤 中耳炎 化脓性 内毒素 可溶性白细胞介素2受体 放疗 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R739.63[医药卫生—临床医学]