食管癌患者外周血IL-6、VEGF、TNF-α及TGF-β与放射性肺损伤的关系

doi:10.3969/j.issn.1004-583X.2021.03.011

摘要/Abstract

摘要：

目的探究食管癌患者外周血白细胞介素6(interleukin-6, IL-6)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、肿瘤坏死因子α(tumor necrosis factor-α, TNF-α)及转化生长因子β(transforming growth factor-β, TGF-β) 水平与放射性肺损伤(radiation induced lung injury, RILI)的关系。方法回顾性分析本院2018年3月至2020年3月收治97例食管癌患者,根据治疗后是否出现RILI分为RILI组(n=25)与非RILI组(n=72),检测两组患者放疗前后外周血IL-6、VEGF、TNF-α及TGF-β水平,分析各项指标与发生RILI的相关性及诊断效能。结果放疗后,RILI组患者IL-6、VEGF、TNF-α及TGF-β指标水平均提高,非RILI组患者各项指标除VEGF均下降(P<0.05);患者是否发生RILI与外周血IL-6、VEGF、TNF-α及TGF-β水平相关性显著(r=-0.564、r=-0.266、r=-0.758、r=-0.583),P<0.05;ROC结果显示,IL-6、VEGF、TNF-α及TGF-β的AUC依次为0.837、0.645、0.989、0.884,敏感度依次为68.0%、88.0%、100.0%、92.0%,特异度依次为91.7%、47.2%、90.3%、77.8%。结论食管癌患者外周血IL-6、VEGF、TNF-α、TGF-β水平均与患者放疗后RILI相关性显著,可作为预测RILI发生的因子。

关键词: 食管肿瘤, 细胞因子类, 放射疗法

Abstract:

Objective To explore the levels of peripheral blood cytokine interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and transforming growth factor-β (TGF-β) in patients with esophageal cancer with relation to radiation-induced lung injury (RILI). Methods Retrospective analysis was performed in 97 patients with esophageal cancer who had been admitted to our hospital from March 2018 to March 2020. According to whether RILI developed after the treatment, the patients were divided into RILI group(n=25) and non-RILI group(n=72). The peripheral blood IL-6, VEGF, TNF-α, and the level of TGF-β for patients in two groups were determined before and after the radiotherapy. The correlation between various indexes and RILI development was analyzed, and diagnostic efficiency was evaluated. Results IL-6, VEGF, TNF-α, and TGF-β in RILI group were increased, and all the indexes except VEGF in non-RILI group were decreased after the radiotherapy(P<0.05). Whether the patients developed RILI had significant correlation with the levels of peripheral blood IL-6, VEGF, TNF-α, and TGF-β (r=-0.564, r=-0.266, r=-0.758, and r=-0.583)(P<0.05). ROC results showed that the AUC of IL-6, VEGF, TNF-α, and TGF-β were successively 0.837, 0.645, 0.989, and 0.884. In addition, their sensitivity and the specificity were 68.0% and 91.7%, 88.0% and 47.2%, 100.0% and 90.3%, and 92.0% and 77.8%, respectively. Conclusion The levels of peripheral blood IL-6, VEGF, TNF-α, and TGF-β in patients with esophageal cancer are significantly correlated with RILI development after the radiotherapy, and they can be used as factors to predict RILI development.

Key words: esophageal neoplasms, cytokines, radiotherapy

中图分类号:

R735.1

赵若妃, 王磊, 李英灿, 李丹, 祝国莲. 食管癌患者外周血IL-6、VEGF、TNF-α及TGF-β与放射性肺损伤的关系[J]. 临床荟萃, 2021, 36(3): 242-245.

Zhao Ruofei, Wang Lei, Li Yingcan, Li Dan, Zhu Guolian. Relation of radiation-induced lung injury to peripheral blood IL-6, VEGF,TNF-α and TGF-β in patients with esophageal cancer[J]. Clinical Focus, 2021, 36(3): 242-245.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.03.011

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I3/242

图/表 5

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临床特征	RILI组 (n=25)	非RILI组 (n=72)	χ²值	P值
性别
男女	11(44.00) 14(56.00)	43(59.72) 29(40.28)	1.859	0.173
年龄
≤60岁 >60岁	8(32.00) 17(68.00)	23(31.94) 49(68.06)	0.000	0.996
吸烟史
有无	5(20.00) 20(80.00)	12(16.67) 60(83.33)	0.143	0.706
KPS评分
≥80分 <80分	12(48.00) 13(52.00)	21(29.17) 51(70.83)	2.932	0.087
既往肺功能
正常异常	7(28.00) 18(72.00)	53(73.61) 19(26.39)	16.362	0.000
TNM分期
Ⅲ期 Ⅳ期	13(52.00) 12(48.00)	44(61.11) 28(38.89)	0.636	0.425
放射剂量
50 Gy 50.4 Gy	19(76.00) 6(24.00)	46(63.89) 26(36.11)	1.231	0.267

临床特征	RILI组 (n=25)	非RILI组 (n=72)	χ²值	P值
性别
男女	11(44.00) 14(56.00)	43(59.72) 29(40.28)	1.859	0.173
年龄
≤60岁 >60岁	8(32.00) 17(68.00)	23(31.94) 49(68.06)	0.000	0.996
吸烟史
有无	5(20.00) 20(80.00)	12(16.67) 60(83.33)	0.143	0.706
KPS评分
≥80分 <80分	12(48.00) 13(52.00)	21(29.17) 51(70.83)	2.932	0.087
既往肺功能
正常异常	7(28.00) 18(72.00)	53(73.61) 19(26.39)	16.362	0.000
TNM分期
Ⅲ期 Ⅳ期	13(52.00) 12(48.00)	44(61.11) 28(38.89)	0.636	0.425
放射剂量
50 Gy 50.4 Gy	19(76.00) 6(24.00)	46(63.89) 26(36.11)	1.231	0.267

组别	例数	IL-6(pg/ml)		VEGF(ng/L)		TNF-α(ng/L)		TGF-β(pg/ml)
组别	例数	放疗前	放疗后	放疗前	放疗后	放疗前	放疗后	放疗前	放疗后
RILI组	25	67.90±17.41	79.02±16.52^*	24.56±6.31	31.48±5.89^*	32.55±6.36	34.30±2.93^*	5107.4±275.31	5846.66±573.67^*
非RILI组	72	68.40±14.24	54.34±15.94^*	25.12±6.05	27.64±6.23^*	31.86±7.12	21.73±5.26^*	5098.56±289.12	4977.07±521.42^*
t值		0.143	6.656	0.394	2.692	0.429	11.329	0.133	7.000
P值		0.887	0.000	0.694	0.008	0.669	0.000	0.894	0.000

组别	例数	IL-6(pg/ml)		VEGF(ng/L)		TNF-α(ng/L)		TGF-β(pg/ml)
组别	例数	放疗前	放疗后	放疗前	放疗后	放疗前	放疗后	放疗前	放疗后
RILI组	25	67.90±17.41	79.02±16.52^*	24.56±6.31	31.48±5.89^*	32.55±6.36	34.30±2.93^*	5107.4±275.31	5846.66±573.67^*
非RILI组	72	68.40±14.24	54.34±15.94^*	25.12±6.05	27.64±6.23^*	31.86±7.12	21.73±5.26^*	5098.56±289.12	4977.07±521.42^*
t值		0.143	6.656	0.394	2.692	0.429	11.329	0.133	7.000
P值		0.887	0.000	0.694	0.008	0.669	0.000	0.894	0.000

变量	IL-6		VEGF		TNF-α		TNF-β
变量	r值	P值	r值	P值	r值	P值	r值	P值
IL-6	-	-	-	-	-	-	-	-
VEGF	0.507	0.000	-	-	-	-	-	-
TNF-α	0.665	0.000	0.490	0.000	-	-	-	-
TNF-β	0.668	0.000	0.628	0.000	0.761	0.000	-	-
病况	-0.564	0.000	-0.266	0.000	-0.758	0.000	-0.583	0.000