新疆医科大学学报2024,Vol.47Issue(1) :86-91,97.DOI:10.3969/j.issn.1009-5551.2024.01.015

宫颈癌放疗患者临床特征、DVH参数及血清细胞因子预测急性放射性肠炎发病的前瞻性队列研究

Prospective cohortstudy of clinical characteristics,DVH parameters and serum cytokines predicting onset ofacute radiation enteritis in patients with cervical cancertreated with radiotherapy

戴颖 臧春宝 张余飞 柯学 刘云琴
新疆医科大学学报2024,Vol.47Issue(1) :86-91,97.DOI:10.3969/j.issn.1009-5551.2024.01.015

宫颈癌放疗患者临床特征、DVH参数及血清细胞因子预测急性放射性肠炎发病的前瞻性队列研究

Prospective cohortstudy of clinical characteristics,DVH parameters and serum cytokines predicting onset ofacute radiation enteritis in patients with cervical cancertreated with radiotherapy

戴颖 1臧春宝 1张余飞 1柯学 1刘云琴1
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作者信息

  • 1. 安徽省肿瘤医院放疗科,合肥 230000
  • 折叠

摘要

目的 探讨宫颈癌放疗患者临床特征、放疗剂量体积直方图(Dose volume histogram,DVH)参数及放疗前血清细胞因子水平等指标对急性放射性肠炎(Acute radiation enteritis,ARE)的预测作用.方法 以2022年3月-2022年12月在安徽省肿瘤医院放疗科接受放射治疗的48例宫颈癌患者为研究对象,记录患者的DVH参数、临床特征(年龄、BMI、疾病分期、病理类型等),收集患者放疗前后的静脉血样本,采用多重微球流式荧光法测定血浆中细胞因子(IL-4、IL-6、IL-10、IL-12p70、IL-17、IFN-γ、TNF-α)的水平.比较以各因素分组ARE的发生率,比较ARE组与非ARE组DVH参数与细胞因子水平.采用Logistic回归分析筛选与ARE发生的相关因素,并采用受试者工作特征Receiver operating characteristic,ROC)曲线分析单因素及多因素模型预测ARE的价值.结果 临床特征、DVH参数及细胞因子水平在ARE组及非ARE组间无差异;以放疗前IL-12p70中位数分组,IL-12p70高水平组ARE发生率较低(P<0.05),以其余细胞因子、DVH参数分组、组间ARE发生率、组间细胞因子水平、DVH参数,ARE发生率差异无统计学意义(P>0.05);Logistic回归分析结果显示临床分期、放疗前血清IL-12p70、IL-17水平与ARE发生相关(P<0.05).ROC曲线分析结果显示含分期、IL-12p70大于中位数、IL-17大于中位数三因素的联合模型具有较高的预测ARE发生的效能(AUC=0.838,P<0.000 1).结论 分期、IL-12p70大于中位数、IL-17大于中位数三因素的联合模型对ARE的发生具有预测价值.

Abstract

Objective To investigate the predictive effects of clinical characteristics,dose volume histogram(DVH)parameters and pre-radiotherapy serum cytokine levels on acute radiation enteritis(ARE)in pa-tients with cervical cancer treated with radiotherapy.Methods 48 patients with cervical cancer who under-went radiotherapy from March 2022 to December 2022 in the hospital were enrolled.The DVH parame-ters,clinical characteristics(age,BMI,disease stage,pathological type,etc.)of the patients were recor-ded,and venous blood samples before and after the radiotherapy were collected to examine the plasma cy-tokines level(IL-4,IL-6,IL-10,IL-12p70,IL-12p70 and IL12p70)using multi-beads flow fluorescence technology.The incidence of ARE among the groups was compared.The DVH parameters and cytokine levels were compared between the ARE group and the non-ARE group.Logistic regression was used to screen the factors that related to the occurrence of ARE.Receiver operating characteristic(ROC)curves were used to evaluate the value of single factors and the multi-factor-model in predicting ARE.Results Clinical characteristics,DVH parameters and cytokine levels did not differ between the ARE and non-ARE groups.Grouped by the median of IL-12p70 before the radiotherapy,the incidence of ARE was lower in IL-12p70 high level group(P<0.05),and there was no statistically significant difference in cytokine lev-els,DVH parametersand ARE incidence between the groups(P>0.05).The results of Logistic regres-sion analysis showed that clinical staging,serum IL-12p70 and IL-17 levels before theradiotherapy were correlated with the occurrence of ARE(P<0.05).The ROC curve analysis results showed that the joint model with stage,IL-12p70 was greater than median,and IL-17 greater than median had high predictive power for ARE occurrence(AUC=0.838,P<0.000 1).Conclusion The combined model containing the 3 factors of staging,IL-12p70 and IL-17 had predictive value for the occurrence of ARE.

关键词

宫颈癌/放疗/急性放射性肠炎/细胞因子/预测

Key words

cervical cancer/radiotherapy/acute radiation enteritis/cytokines/prediction

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基金项目

安徽省自然科学基金(2108085B69)

出版年

2024
新疆医科大学学报
新疆医科大学

新疆医科大学学报

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影响因子:0.76
ISSN:1009-5551
参考文献量21
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