摘要
目的研究食管癌患者血清肿瘤异常蛋白(TAP)预测放射性肺损伤的临床价值及相关性分析。方法选择130例食管癌患者为研究对象,统计放射性肺损伤患者数,评定分级,比较有无放射性肺损伤患者的临床资料;在放疗前、中、后检测患者血清TAP水平,分析患者放射治疗不同时期血清TAP的表达以及不同分级的放射性肺损伤的TAP表达。采用logistic回归进行放射肺损伤多因素分析,ROC曲线评估TAP诊断放射性肺损伤价值,Spearman相关性分析TAP表达与放射性肺损伤。结果130例食管癌患者有65例出现放射性肺损伤,分别为1级13例、2级26例、3级26例。有放射性肺损伤的患者V10、V20、V30、V40以及全肺平均剂量,血清TAP表达明显高于无放射性肺损伤患者(t分别=4.31、9.79、29.56、22.43、22.17、4.98,P均<0.05);各放疗时间食管癌患者的放射性肺损伤分级越高,血清TAP的表达越高(F分别=12.22、13.21、7.89、9.34、8.37、9.22,P均<0.05);并且随着放疗次数的增加,同级肺损伤患者血清的TAP水平逐渐降低(F分别=8.42、9.44、10.22、11.32,P均<0.05);V30、全肺平均放射剂量及血清TAP是患者发生放射性肺损伤的影响因素(OR分别=1.79、2.10、1.91,P均<0.05);血清TAP表达较其他指标于食管癌患者放射性肺损伤有较好诊断价值(诊断特异度87.66%,灵敏度90.23%);血清TAP的表达与患者放疗后发生放射性肺损伤程度呈正相关(rs=0.45,P<0.05)。结论食管癌患者不同放疗时期血清TAP表达对于肺损伤具有较好的临床诊断价值,且血清TAP是放射性肺损伤的影响因素,TAP或可成为临床控制食管癌患者发生放射性肺损伤的靶标因子。
Objective To explore the clinical value and correlation of serum TAP in predicting radiation-induced lung injury in esophageal cancer patients.Methods The 130 cases with esophageal cancer were collected,and the patients with radiation-induced lung injury were counted and graded.And the clinical data between patients with radiation-induced lung injury and patients without radiation-induced lung injury were compared.The levels of serum TAP were measured before,during and after radiotherapy.The expression of serum TAP among different times and different grades of radiation-induced lung injury were compared.Logistic was used to analyze the risk factors of radiation-induced lung injury.ROC curve was used to evaluate the diagnostic value of TAP in radiation-induced lung injury.Spearman correlation analysis was used to analyze the expression of TAP and radiation-induced lung injury.Results There were 65 cases of radiation lung injury in 130 patients with esophageal cancer,including 13 cases of grade 1,26 cases of grade 2 and 26 cases of grade 3.The levels of V10,V20,V30,V40,the average dose,and the expression of serum TAP of whole lung in patients with radiation-induced lung injury were significantly higher than those without radiation-induced lung injury(t=4.31,9.79,29.56,22.43,22.17,4.98,P<0.05).The higher the grade of radiation-induced lung injury in patients with esophageal cancer,the higher the expression of serum TAP(F=12.22,13.21,7.89,9.34,8.37,9.22,P<0.05).With the increase of the times of radiotherapy,the level of serum TAP in patients with same grade lung injury decreased gradually(F=8.42,9.44,10.22,11.32,P<0.05),The V30,average radiation dose of whole lung,and serum TAP were the influencing factors of radiation-induced lung injury in patients with radiation-induced lung injury(OR=1.79,2.10,1.91,P<0.05).Compared with other indexes,the expression of serum TAP has better diagnostic value in radiation-induced lung injury in patients with esophageal cancer,its diagnostic specificity was 87.66%,the sensitivity was 90.23%.The expression of serum TAP is positively correlated with the degree of radiation-induced lung injury after radiotherapy(rs=0.45,P<0.05).Conclusion The expression of TAP in serum at different radiotherapy stages in patients with esophageal cancer has good clinical diagnostic value for lung injury.TAP is an influential factor of radioactive lung injury,which may be a target factor for clinical control of radioactive lung injury in patients with esophageal cancer.
作者
刘学武
刘敏
姜忠于
王立
胡春秀
LIU Xuewu;LIU Min;JIANG Zhongyu(Department of Radiotherapy,Zhejiang Quhua Hospital,Quzhou 324004,China)
出处
《全科医学临床与教育》
2020年第12期1084-1087,1094,共5页
Clinical Education of General Practice
基金
衢州市科技项目(2018ASA90261)
衢州市科技项目(2018ASA90040)。
关键词
食管癌
血清肿瘤异常蛋白
放射性肺损伤
相关性
esophageal cancer
serum tumor abnormal protein
radiation-induced lung injury
relativity
