鼻咽癌患者血清IFN-γ、PTX3及EGF水平对放疗效果的预测价值

Predictive value of serum IFN-γ,PTX3 and EGF levels for radiotherapy effect in patients with nasopharyngeal carcinoma

目的 探讨鼻咽癌患者血清干扰素-γ(IFN-γ)、血清穿透素3(PTX3)、表皮生长因子(EGF)水平对放疗效果的预测价值。方法 选取2015年3月至2018年7月于石家庄平安医院就诊的112例鼻咽癌患者作为研究对象(NPC组),选取同期112名健康体检者作为对照组,采用酶联免疫吸附试验(ELISA)检测两组血清中的IFN-γ、PTX3、EGF水平。根据实体瘤的疗效评价标准将NPC患者分为有效组和无效组,比较两组血清中的IFN-γ、PTX3、EGF水平。根据随访结果将NPC组分为生存组和死亡组,比较两组血清中的IFN-γ、PTX3、EGF水平。分析IFN-γ、PTX3、EGF对放疗效果的评价及诊断预后的预测价值。结果 NPC组IFN-γ水平显著低于对照组,PTX3和EGF水平显著高于对照组,差异均有统计学意义(P<0.05)。放疗后有效组IFN-γ水平显著高于无效组,PTX3和EGF水平显著低于无效组,差异均有统计学意义(P<0.05)。放疗后生存组IFN-γ水平显著高于死亡组,PTX3和EGF水平显著低于死亡组,差异均有统计学意义(P<0.05)。根据AUC选取IFN-γ、PTX3和EGF的最佳诊断截点,ROC曲线分析显示,IFN-γ、PTX3、EGF联合预测的AUC为0.936,高于三者单独检测(P<0.05)。结论 鼻咽癌患者中血清IFN-γ表达降低,PTX3和EGF表达升高,三指标对鼻咽癌患者放疗效果的评价和诊断预后具有重要的价值。

Objective To explore the predictive value of serum interferon-γ(IFN-γ),pentraxin 3(PTX3)and epidermal growth factor(EGF)for radiotherapy effect in patients with nasopharyngeal carcinoma(NPC). Methods A total of 112 patients with NPC treated in Shijiazhuang Pingan Hospital were enrolled as the NPC group between March 2015 and July 2018,while other 112 healthy controls during the same period were enrolled as the control group. The levels of serum IFN-γ,PTX3 and EGF were detected by enzymelinked immunosorbent assay(ELISA). According to the efficacy evaluation criteria of solid tumors,NPC patients were divided into the effective group and the ineffective group,and levels of serum IFN-γ,PTX3 and EGF were compared between the two groups. According to the follow-up results,the NPC group were divided into the survival group and the death group,and levels of serum IFN-γ,PTX3 and EGF were compared between the two groups. The evaluation of IFN-γ,PTX3 and EGF on the effect of radiotherapy and the predictive value of diagnosis and prognosis were analyzed. Results The level of serum IFN-γ in the NPC group was significantly lower than that in the control group,while levels of PTX3 and EGF were significantly higher than those in the control group(P<0.05). After radiotherapy,the level of serum IFN-γ in the effective group was significantly higher than that in the ineffective group,while levels of PTX3 and EGF were significantly lower than those in the ineffective group(P<0.05). After radiotherapy,the level of serum IFN-γ in the survival group was significantly higher than that in the death group,while levels of PTX3 and EGF were significantly lower than those in the death group(P<0.05). The best diagnostic cut-off values of IFN-γ,PTX3 and EGF were selected according to AUC values. ROC curve analysis showed that AUC of IFN-γ combined with PTX3 and EGF for predicting radiotherapy effect was 0.936,which was higher than that of the three alone(P<0.05).Conclusion The expression of serum IFN-γ was decreased in patients with nasopharyngeal carcinoma,and the expressions of PTX3 and EGF were increased. The three indicators have important value in the evaluation of radiotherapy effect and the diagnosis and prognosis of patients with nasopharyngeal carcinoma.