血清转化生长因子β1、白细胞介素-6、Toll样受体-4、核转录因子κB联合评估非小细胞肺癌放射性肺炎病情严重程度的价值

张静; 毛英

doi:10.7619/jcmp.20234065

血清转化生长因子β1、白细胞介素-6、Toll样受体-4、核转录因子κB联合评估非小细胞肺癌放射性肺炎病情严重程度的价值

张静,
毛英

Value of combined assessment of serum transforming growth factor-β1, interleukin-6, toll-like receptor-4, and nuclear factor-κb in evaluating the severity of radiation pneumonitis in non-small cell lung cancer

摘要

摘要:
目的探讨血清转化生长因子β1(TGF-β1)、白细胞介素-6(IL-6)、Toll样受体-4(TLR-4)和核转录因子κB (NF-κB)联合评估非小细胞肺癌(NSCLC)放射性肺炎(RP)病情严重程度的价值。
方法选取104例NSCLC放疗后继发RP患者作为研究组, 另选取52例NSCLC放疗后未继发RP患者作为对照组。比较2组患者放疗前后血清TGF-β1、IL-6、TLR-4、NF-κB水平。比较研究组不同程度RP患者放疗前后血清TGF-β1、IL-6、TLR-4、NF-κB水平, 分析各血清指标单独及联合评估NSCLC放疗后RP病情程度的价值。
结果放疗结束后, 研究组患者血清TGF-β1、IL-6、TLR-4、NF-κB水平均高于对照组, 差异有统计学意义(P < 0.05);放疗结束后, 随着RP病情程度的增加, 研究组患者血清TGF-β1、IL-6、TLR-4、NF-κB水平呈升高趋势, 差异有统计学意义(P < 0.05)。受试者工作特征(ROC)曲线分析结果显示, 放疗结束后血清TGF-β1、IL-6、TLR-4、NF-κB水平评估1级RP的曲线下面积(AUC)分别为0.787、0.718、0.783、0.801, 评估≥2级RP的AUC分别为0.729、0.740、0.793、0.825;血清TGF-β1、IL-6、TLR-4、NF-κB阳性表达患者发生≥2级RP的风险分别是阴性表达患者的2.473、2.275、2.610、5.267倍(P < 0.05);血清TGF-β1、IL-6、TLR-4、NF-κB联合评估≥2级RP的AUC为0.939, 敏感度为76.00%, 特异度为97.47%。
结论 NSCLC患者放疗结束后血清TGF-β1、IL-6、TLR-4、NF-κB水平均与RP病情严重程度呈正相关, 四者联合评估≥2级RP的价值显著, 可为临床控制RP病情提供参考依据。

Abstract:
Objective To explore the value of combined assessment of serum transforming growth factor-β1(TGF-β1), interleukin-6(IL-6), Toll-like receptor-4(TLR-4), and nuclear factor-κB (NF-κB) in evaluating the severity of radiation pneumonitis (RP) in non-small cell lung cancer (NSCLC) patients.
Methods A total of 104 NSCLC patients with secondary RP after radiotherapy were selected as study group, and 52 NSCLC patients without secondary RP after radiotherapy were selected as control group.Serum levels of TGF-β1, IL-6, TLR-4, and NF-κB before and after radiotherapy were compared between the two groups.The levels of these serum markers in RP patients with different severity in the study group were also compared.The value of each serum marker alone and their combination for assessing the severity of RP after NSCLC radiotherapy was analyzed.
Results After radiotherapy, the serum levels of TGF-β1, IL-6, TLR-4, and NF-κB in the study group were significantly higher than those in the control group (P < 0.05).After radiotherapy, with the increase in the severity of RP, the serum levels of TGF-β1, IL-6, TLR-4, and NF-κB in the study group showed an increasing trend (P < 0.05).Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for assessing grade 1 RP was 0.787 for TGF-β1, 0.718 for IL-6, 0.783 for TLR-4, and 0.801 for NF-κB, while the AUC for assessing ≥ grade 2 RP was 0.729, 0.740, 0.793, and 0.825, respectively.The risk of developing ≥ grade 2 RP in patients with positive expression of serum TGF-β1, IL-6, TLR-4, and NF-κB was 2.473, 2.275, 2.610, and 5.267 times higher than that in patients with negative expression, respectively (P < 0.05).The AUC for combined assessment of ≥ grade 2 RP using serum TGF-β1, IL-6, TLR-4, and NF-κB was 0.939, with a sensitivity of 76.00% and a specificity of 97.47%.
Conclusion The serum levels of TGF-β1, IL-6, TLR-4, and NF-κB in NSCLC patients after radiotherapy are positively correlated with the severity of RP.The combined assessment of these four markers has significant value in evaluating ≥ grade 2 RP and can provide a reference for clinical control of RP.

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