食管癌放疗患者血清涎液化糖链抗原水平检测在预测放射性肺炎的风险评估

Serum KL-6 Predicts the Risk of Pneumonitis Induction after Radiotherapy of Esophageal Cancer

目的探讨食管癌患者在放疗前后血清中涎液化糖链抗原(krebs von den Lungen-6,KL-6)水平的变化在预警放射性肺炎(radiation pneumonitis,RP)发生的价值。方法对39例在2017年7~12月期间接受放射治疗的食管癌患者进行随访,留取放疗开始前及放疗开始后的1,2,3,4个月内的血清,将其分为RP组(9例)和非RP组(30例),采用电化学发光法(ECLI)检测两组患者血清中KL-6水平的变化。结果放疗前,RP组和非RP组的血清KL-6水平差异无统计学意义(t=1.480,P=0.147),而从放疗开始后的1~4个月,RP组的血清KL-6水平显著高于非RP组,差异有统计学意义(t=6.977,P=0.001和t=0.530,P=0.602),对放疗前后KL-6水平增高比值进行工作特征曲线(ROC)分析,结果显示最佳诊断界限为1.4,灵敏度,特异度和AUC分别为66.7%,96.7%,0.934。结论血清KL-6水平在监测食管癌患者发生RP方面有重要意义,当食管癌病人接受放疗后血清KL-6水平升高且与放疗前水平之比大于1.4时,提示该患者罹患RP的可能性较大。

Objective To study the serum levels of KL-6 in predicting radiation pneumonia(RP)before and after radiotherapy.Methods A total of 39 hospitalized patients with esophageal cancer were followed up between July to December in 2017.To collect the serum of 39 patients before and after the treatment in 1,2,3 and 4 months.The patients were divided into the RP group(9 cases)and non-RP group(30 cases).The levels of KL-6 changes in the two groups were detected by electrochemiluminescence immunoassay(ECLI).Results Before radiotherapy,there was no significant difference(t=1.480,P=0.1471)in serum KL-6 between RP group and non RP group.From 1~4months after radiotherapy,the serum KL-6 levels in RP group was significanty higher than that in non RP group(t=6.977,P=0.001,t=0.530,P=0.602).ROC analysis showed that the best diagnostic limit was 1.4 and the sensitivity,specificity and AUC were 66.7%,96.7%and 0.934 respectively.Conclusion The levels of serum KL-6 is of great clinical significance in monitoring RP of esophageal cancer patients,that is,when the levels of serum KL-6 increases after radiotherapy and the ratio of KL-6 to the levels before radiotherapy was greater than 1.4,it indicates that the patients are more likely to have RP.