ⅢB/Ⅳ期肺癌患者放疗前后中医辨证分型与RAD51的关系

Relationship between traditional Chinese medicine syndrome differentiation and RAD51 in stage ⅢB/Ⅳ non-small cell lung cancer patients before and after radiotherapy

目的探讨ⅢB/Ⅳ期非小细胞肺癌(NSCLC)患者放射治疗前后中医辨证分型与RAD51之间的关系。方法选择2015年5月~2018年5月解放军联勤保障部队第四七六医院肿瘤科收治的ⅢB/Ⅳ期NSCLC患者85例,在放疗前后给予中医辨证分型,并通过酶联免疫吸附测定试验检测患者血清RAD51水平。比较NSCLC患者放疗后中医证型变化情况、临床疗效、放射性肺炎发生情况、RAD51表达变化情况及放疗疗效与RAD51的关系。结果NSCLC患者放疗后肺郁痰瘀、阴虚痰热、脾虚痰湿证型比例与放疗前比较,差异有统计学意义(P<0.05或P<0.01)。不同证型患者临床疗效差异有统计学意义(P<0.05),放射性肺炎分级差异无统计学意义(P>0.05)。放疗后肺郁痰瘀、阴虚痰热、脾虚痰湿证型患者RAD51表达水平明显低于放疗前,差异有高度统计学意义(P<0.01),气阴两虚证患者放疗前后RAD51表达水平差异无统计学意义(P>0.05)。结论放疗前后中医辨证分型和RAD51表达情况对预测NSCLC放疗疗效具有重要意义。放疗后RAD51表达情况可以作为中医辨证分型的依据。RAD51与中医证型可以相辅相成,共同指导个体化放疗。

Objective To investigate the relationship between traditional Chinese medicine syndrome differentiation and serum levels of RAD51 in patients with stageⅢB/Ⅳnon-small cell lung cancer(NSCLC)before and after radiotherapy.Methods From May 2015 to May 2018,85 patients with stageⅢB/ⅣNSCLC admitted to the Department of Oncology of No.476 Hospital of the Joint Logistics Team of PLA were selected.The syndrome differentiation of traditional Chinese medicine was carried out in these NSCLC patients before and after radiotherapy,and serum levels of RAD51 were measured by the enzyme-linked immunosorbent assay method.The changes of traditional Chinese medicine syndromes,clinical efficacy,occurrence of radioactive pneumonia,expression changes of RAD51 and the relationship between radiotherapy efficacy and RAD51 in NSLCL patients were compared.Results After radiotherapy,the percentage of NSLCL patients with syndrome of lung stagnation and phlegm and blood stasis,yin deficiency phlegm heat,spleen deficiency with damp phlegm had statistically significant differences compared with those before radiotherapy(P<0.05 or P<0.01).The differences of clinical efficacy in different syndrome types were statistically significant(P<0.05).There was no statistically significant difference in the classification of radiation pneumonitis(P>0.05).After radiotherapy,the expression of RAD51 in patients with the syndrome of lung stagnation phlegm and blood stasis,yin deficiency phlegm heat,spleen deficiency with damp phlegm were significantly lower than those before radiotherapy,the differences were highly statistically significant(P<0.01).There was no significant difference in the expression of RAD51 in the patients with syndrome of deficiency of both qi and yin before and after radiotherapy(P>0.05).Conclusion Traditional Chinese medicine syndrome differentiation and RAD51 expression before and after radiotherapy are important for predicting the efficacy of NSCLC radiotherapy.The expression of RAD51 after radiotherapy can be used as the basis of traditional Chinese medicine syndrome differentiation.RAD51 and traditional Chinese medicine syndromes can complement each other to guide individualized radiotherapy.The expression of RAD51 after radiotherapy can be used as the evidence of traditional Chinese medicine syndrome differentiation.RAD51 and traditional Chinese medicine syndromes complement each other and serve as an effective way to guide individualized radiotherapy.