血清肺表面活性蛋白A动态变化与非小细胞肺癌患者放射性肺炎发生的相关研究

Study of Correlation between Pulmonary Surfactant A Levels in Serum and Radiation Pneumonitis in Patients with Non-Small Cell Lung Cancer

目的:探讨接受放疗的非小细胞肺癌(NSCLC)患者血清中肺表面活性蛋白A(PS-A)水平的动态变化与放射性肺炎(RP)发生的关系。方法:对68例接受三维适形放疗的Ⅲ期肺癌患者采用酶联免疫吸附法(ELISA)检测于放疗前、放疗剂量达40～50 Gy时及放疗后4周血清中PS-A水平。结果:25例患者发生RP。RP者中放疗前PS-A为(38.6±20.8)ng/mL,放疗中升高达(51.4±19.3)ng/mL(P<0.05),放疗后PS-A高于放疗前[(78.2±21.5)ng/mL;P<0.05]。在无RP者中放疗前PS-A与放疗中、后均相似(P>0.05)。RP者与无RP者中放疗前PS-A相似(P>0.05),放疗中及放疗后前者PS-A明显高于后者(P<0.05)。结论:PS-A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。

Objective： To correlate the pulmonary surfactant A（PS-A） levels in non-small cell lung cancer（NSCLC）patients during 3-dimensional conformal radiation therapy（3-DCRT） with the occurrence of radiation pneumonitis（RP）. Methods： Sixty-eight patients of lung cancer stagelIIwere evaluated prospectively by enzyme-linked immunosorbent assay（ELISA） for serum PS-A levels before 3-DCRT after 40-50 Gy and 4 weeks after 3-DCRT. Results： Twenty-five patients had RP. In RP patients, the serum PS-A level was（38.6＋ 20.8） ng/mL, PS-A increased to（51.4± 19.3）ng/mL（P〈0.05）after 40-50 Gy. After 3-DCRT PS-A was higher（78.2± 21.5）ng/mL than that before 3-DCRT （P〈0.05）. In non-RP patients, PS-A wags not yet change in three times （P〉0.05）. PS-A was not yet change between RP and non-RP patients before 3-DCRT（P〉0.05）, and PS-A was higher in RP group than that in non-RP group after 40-50Gy and 3-DCRT （P〈0. 05）. Conclusions： The levels of PS-A are closely related to the occurrence of RP. Monitoring the changes in dynamic stale Could predict the generation of RP, which could be employed as sensitive index for indicating risks for acute RP.