不同类型肺癌患者氧化应激状态及其相关因素研究

Oxidative Stress Status and Its Related Factors in Patients with Different Types of Lung Cancer

背景机体氧化系统和抗氧化系统失衡可导致氧化应激,而氧化应激又与多种类型肿瘤的发生发展、临床病理特征等有关,但其在不同类型肺癌患者中的状态尚不清楚。目的分析不同类型肺癌患者氧化应激状态,并探讨肺癌患者氧化应激的相关因素,以为肺癌的防治措施提供一定思路。方法选取2018年在河北工程大学附属医院确诊的肺癌患者110例,其中小细胞肺癌30例(A组)、肺腺癌34例(B组)、肺鳞状细胞癌46例(C组)。另选取同期在该院体检中心进行体检的健康者40例作为对照组。采用酶联免疫吸附试验检测血浆活性氧(ROS)水平,采用羟胺法检测血浆超氧化物歧化酶(SOD)活性,采用TBA法检测血浆丙二醛(MDA)水平。比较四组受试者血浆ROS水平、SOD活性及MDA水平,以肺癌患者血浆ROS水平、SOD活性及MDA水平的均数为截点进行二分类转换,分别比较不同临床病理特征肺癌患者血浆ROS水平、SOD活性及MDA水平,并采用Kendall's tau-b等级相关分析探讨肺癌患者临床病理特征与血浆ROS水平、SOD活性及MDA水平的相关性。结果A、B、C组患者血浆ROS、MDA水平高于对照组,血浆SOD活性低于对照组(P<0.05);B、C组患者血浆ROS、MDA水平低于A组,血浆SOD活性高于A组(P<0.05)。有无吸烟史及不同病理分级肺癌患者血浆ROS水平比较,差异有统计学意义(P<0.05)。Kendall's tau-b等级相关分析结果显示,肺癌患者血浆ROS水平与吸烟史呈正相关(Kendall's tau-b=0.572,P<0.05),与病理分级呈负相关(Kendall's tau-b=-0.454,P值均<0.05)。有无吸烟史及不同病理分级、肿瘤大小肺癌患者血浆SOD活性比较,差异有统计学意义(P<0.05)。Kendall's tau-b等级相关分析结果显示,肺癌患者血浆SOD活性与吸烟史、肿瘤大小呈负相关(Kendall's tau-b值分别为-0.614、-0.951,P值均<0.05),与病理分级呈正相关(Kendall's tau-b=0.732,P<0.05)。有无吸烟史及不同病理分级、肿瘤大小肺癌患者血浆MDA水平比较,差异有统计学意义(P<0.05)。Kendall's tau-b等级相关分析结果显示,肺癌患者血浆MDA水平与吸烟史、肿瘤大小呈正相关(Kendall's tau-b值分别为0.479、0.790,P值均<0.05)。结论肺癌患者氧化能力增强、抗氧化能力减弱、氧化损伤增加,尤其是小细胞肺癌患者,且肺癌患者氧化应激水平与吸烟史、病理分级、肿瘤大小有关。

Background Oxidative stress occurs by the imbalance between oxidation system and antioxidant system.Oxidative stress is related to the occurrence and development,clinicopathological characteristics of various types of tumor.But its status in patients with different types of lung cancer is not clear.Objective To analyze the oxidative stress status in patients with different types of lung cancer,and to explore the influencing factors of oxidative stress in patients with lung cancer,in order to provide some ideas for the prevention and treatment of lung cancer.Methods 110 lung cancer patients were collected in Affiliated Hospital of Hebei University of Engineering in 2018,including 30 cases of small cell lung cancer(A group),34 cases of lung adenocarcinoma(B group)and 46 cases of lung squamous cell carcinoma(C group),and another 40 healthy people who had physical examination in the physical examination center of our hospital during the same period were selected as the control group.ELISA was used to detect plasma ROS level,hydroxylamine method was used to detect plasma SOD activity,TBA method was used to detect plasma MDA level.The ROS level,SOD activity and MDA level in plasma were compared among the four groups,and were converted into two-category variables respectively with the mean values of ROS level,SOD activity and MDA level as cut-off points,then the ROS level,SOD activity and MDA level in patients with lung cancer with different clinicopathological characteristics were compared,and Kendall's tau-b grade correlation was used to analyze the correlation between clinicopathological characteristics and ROS level,SOD activity and MDA level in plasma.Results The plasma ROS and MDA levels in A,B and C groups were higher than those in control group,while plasma SOD activity was lower than that in control group(P<0.05);plasma ROS and MDA levels in B and C groups were lower than those in A group,plasma SOD activity was higher than that in A group(P<0.05).There were statistically significant differences in plasma ROS level between patients with or without smoking history and with different pathological grades(P<0.05).Kendall's tau-b grade correlation analysis results showed that,the plasma ROS level was positively correlated with smoking history(Kendall's tau-b=0.572,P<0.05),and negatively correlated with pathological grade(Kendall's tau-b=-0.454,P<0.05).There were statistically significant difference in plasma SOD activity between patients with or without smoking history,with different pathological grades and tumor sizes(P<0.05).Kendall's tau-b grade correlation analysis results showed that,the plasma SOD activity was negatively correlated with smoking history and tumor size(Kendall's tau-b value was-0.614,-0.951;P<0.05),and positively correlated with pathological grade(Kendall's tau-b=0.732,P<0.05).There were statistically significant difference in plasma MDA level between patients with or without smoking history,with different pathological grades and tumor sizes(P<0.05).Kendall's tau-b grade correlation analysis results showed that,the plasma MDA level was positively correlated with smoking history and tumor size(Kendall's tau-b=0.479,0.790;P<0.05),and negatively correlated with pathological grade(Kendall's tau-b=-0.479,P<0.05).Conclusion In patients with lung cancer,the oxidizing ability is enhanced,the antioxidant ability is decreased,and oxidative damages are increased,especially in patients with small cell lung cancer;and the level of oxidative stress may be correlated with smoking history,pathological grade and tumor size.