Interaction and predictive efficacy of nuclear factor erythroid 2-related factor 2(Nrf2)and nuclear factor κB(NF-κB)on radiation mucositis in patients with nasopharyngeal carcinoma
Objective To investigate the interaction and predictive efficacy of nuclear factor erythroid 2-re-lated factor 2(Nrf2)and nuclear factor κB(NF-κB)on radiation mucositis in patients with nasopharyngeal carcinoma.Methods A total of 116 patients with nasopharyngeal carcinoma in the hospital from August 2021 to February 2023 were selected,all of whom were treated with radiotherapy.According to the occur-rence of radioactive mucositis at the 3rd week of radiotherapy,the patients were divided into asymptomatic group(grade 0),mild group(grade 1-2)and severe group(grade 3-4).The levels of serum Nrf2 and NF-κB in 3 groups were compared.Spearman rank correlation coefficient was used to analyze the relation-ship between serum Nrf2,NF-κB levels and the incidence of radiation mucositis.Receiver operating char-acteristic curve(ROC curve)was used to analyze the predictive value of serum Nrf2 and NF-κB levels on the risk of severe radiation mucositis.The influencing factors of severe radiation mucositis and the interac-tion between Nrf2 and NF-κB on severe radiation mucositis were analyzed.Results Serum Nrf2 level in severe group was lower than that in mild group and asymptomatic group,serum NF-κB level was higher than that in mild group and asymptomatic group,serum Nrf2 level in mild group was lower than that in asymptomatic group,and serum NF-κB level was higher than that in asymptomatic group(P<0.05).There was a low negative correlation between serum Nrf2 level and the occurrence of radiation mucositis before radiotherapy(r=-0.452,P<0.001),and a moderate negative correlation between serum Nrf2 level and the occurrence of radiation mucositis after 1 week of radiotherapy(r=-0.586,P<0.001),and a moderate negative correlation between serum Nrf2 level and the occurrence of radiation mucositis after 3 weeks of radiotherapy(r=-0.620,P<0.001).There was a low positive correlation between serum NF-κB level and the incidence of radiation catarrh before radiotherapy(r=0.475,P<0.001),and a moderate positive correlation between serum NF-κB level and the incidence of radiation catarrh after 1 week of radio-therapy(r=0.541,P<0.001),and a moderate positive correlation between serum NF-κB level and the incidence of radiation catarrh after 3 weeks of radiotherapy(r=0.619,P<0.001).Serum Nrf2 level after 1 week of prophylactic medication and radiotherapy were independent protective factors for severe radiation mucositis,while smoking history,radiotherapy dose and serum NF-κB level after 1 week of radiotherapy were independent risk factors for severe radiation mucositis(P<0.05).The AUC value of serum Nrf2 and NF-κB combined to predict the occurrence of severe radiation mucositis was 0.829,which was higher than that of serum Nrf2(Z=2.519,P=0.012),NF-κB(Z=2.084,P=0.037)levels alone predicted AUC values of 0.730 and 0.764(P<0.05).Nrf2 and NF-κB had antagonistic effects on the occurrence of severe radiation mucositis(S<1).About 31.6%of the risk of severe radiation mucositis co-existed with Nrf2 and NF-κB was caused by their interaction.Conclusion The changes of serum Nrf2 and NF-κB levels in patients with nasopharyngeal carcinoma are closely related to the occurrence and development of radia-tion mucositis,and the detection of the changes of the 2 levels can provide a reference for clinical prediction of the occurrence of severe radiation mucositis.
NETL
NSTL
万方数据
