中华放射医学与防护杂志

戴晓芳,伍钢,刘莉,等.血浆TGF-β、TNF-α及IL-10水平在预测放射性肺炎中的价值研究[J].中华放射医学与防护杂志,2009,29(1):77-79.DAI Xiao-fang,WU Gang,LIU Li,et al.Research on forecasting values of the plasma levels for TGF-β, TNF-α and IL-10 in radiation pneumonitis[J].Chin J Radiol Med Prot,2009,29(1):77-79

血浆TGF-β、TNF-α及IL-10水平在预测放射性肺炎中的价值研究

Research on forecasting values of the plasma levels for TGF-β, TNF-α and IL-10 in radiation pneumonitis

投稿时间：2008-08-29

DOI：10.3760/cma.j.issn.0254-5098.2009.01.024

中文关键词: 放射性肺炎细胞因子预测价值

英文关键词:Radiation pneumonitis Cytokines Forecasting value

基金项目:

作者	单位	E-mail
戴晓芳	430023 武汉, 华中科技大学同济医学院附属协和医院肿瘤中心
伍钢	430023 武汉, 华中科技大学同济医学院附属协和医院肿瘤中心
刘莉	430023 武汉, 华中科技大学同济医学院附属协和医院肿瘤中心	liulixiehe2004@163.com
喻杰	430023 武汉, 华中科技大学同济医学院附属协和医院肿瘤中心
丁乾	430023 武汉, 华中科技大学同济医学院附属协和医院肿瘤中心
赵艳霞	430023 武汉, 华中科技大学同济医学院附属协和医院肿瘤中心
柯杨	430023 武汉, 华中科技大学同济医学院附属协和医院肿瘤中心

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中文摘要:

目的探讨接受放疗的胸部肿瘤患者血液中TNF-α、TGF-β、IL-10水平变化与放射性肺炎(RP)的关系。方法对69例接受三维适形放疗的Ⅲ期肺癌或食管癌患者采用酶联免疫吸附实验法于放疗前、放疗剂量达40~50 Gy时及放疗后检测血浆中TNF-α、TGF-β和IL-10水平,并计算IL-10/TNF-α比值。结果 28例患者发生RP。RP者中放疗前TGF-β、TNF-α、IL-10和IL-10/TNF-α分别为(15.2±13.4)μg/L、(28.4±13.4)、(24.1±17.1)ng/L和1.01±0.86;放疗中TNF-α升高达(36.1±15.5)ng/L(t=2.01,P=0.040),IL-10下降达(18.8±10.8)ng/L(t=1.40,P=0.166),IL-10/TNF-α下降为0.62±0.55(t=1.90,P=0.063);放疗后TNF-α高于放疗前[(36.9±15.5)ng/L;t=-2.20,P=0.032],IL-10和IL-10/TNF-α分别为(13.7±6.2)ng/L和0.41±0.21,明显低于放疗前(t=3.03,P=0.005;t=3.60,P=0.001);TGF-β在放疗前、中、后均相似(P＞0.05)。在无RP者中放疗前TGF-β、TNF-α、IL-10和IL-10/TNF-α与放疗中、后均相似(P＞0.05)。RP者与无RP 者中放疗前TGF-β相似(t=0.54,P=0.594),放疗中前者TNF-α明显高于后者(t=2.02,P=0.048),放疗后前者IL-10和IL-10/TNF-α明显低于后者(t=2.50,P=0.015;t=4.63,P=0.000)。结论 TNF-α和IL-10水平变化与RP发生密切相关,动态监测其变化可早期预测RP发生,可作为急性放射性肺损伤易感性指标。

英文摘要:

Objective To study the relationship between plasma TGF-β, TNF-α, IL-10 levels and radiation pneumonitis (RP) in patients received thoracic irradiation with 3DCRT. Methods Sixty-nine patients of lung cancer stage Ⅲ or esophageal carcinoma were evaluated prospectively by ElISA for plasma TNF-α, TGF-β, IL-10 levels and IL-10/TNF-αbefore 3DCRT, after 40-50 Gy and after 3DCRT.Results Twenty-eight patients had RP. In RP patients, the plasma TGF-β, TNF-α, IL-10 levels and IL-10/TNF-αwas (15.2±13.4)μg/L,(28.4±13.4),(24.1±17.1) ng/L and 1.01±0.86 before 3DCRT, respectively; TNF-αincreased to (36.1±15.5) ng/L(t=2.01,P=0.040), IL-10 and IL-10/TNF-αdecreased to (18.8±10.8) ng/L (t=1.40,P=0.166)and 0.62±0.55 (t=1.90,P=0.063)after 40-50 Gy. After 3DCRT TNF-α was higher (36.9±15.5) ng/L than that before 3DCRT(t=-2.20,P=0.032),but IL-10 and IL-10/TNF-α were lower than that before 3DCRT [(13.7±6.2) ng/L, t=3.03, P=0.005;0.41±0.21,t=3.60,P=0.001]. TGF-β was not change in three times(P＞0.05).In non-RP patients, TGF-β,TNF-α, IL-10 and IL-10/TNF-αwas not yet change in three times(P＞0.05) respectively. TGF-β was not yet change between RP and non-RP patients before 3DCRT(t=0.54,P=0.594), and TNF-αwas higher in RP group than that in non_RP group after 40-50 Gy(t=2.02,P=0.048),but IL-10 and IL-10/TNF-α was less in RP group than that in non_RP group after 3DCRT(t=2.50,P=0.015;t=4.63,P=0.000). Conclusion The levels of TNF-α and IL-10 are closely related to the occurrence of RP. Monitoring the changes in dynamic state could predict the generation of RP, which could be employed as a sensitive index for indicating risks for acute RP.

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