关键词: 癌, 非小细胞肺, 辐射性肺炎, 转化生长因子&beta, 1

Abstract: ［Abstract］ ObjectiveTo assess the value of serum transforming growth factorβ1(TGFβ1) in predicting the radioactive pneumonia(RP) and the shortterm effect, and to provide a reference for radiotherapy(RT) of nonsmall cell lung cancer(NSCLC). MethodsAn analysis was performed on the medical records of 264 cases with NSCLC. The pathology was confirmed via histology or cytology, using three dimensional conformal radiation therapy. The serum TGFβ1 level was detected before and after RT for all the patients. The TGFβ1 level in serum was detected with enzymelinked immunosorbent assay. Shortterm effect was evaluated according to the WHO unified evaluation criterion after a month of radiotherapy and RP was diagnosed by Radiation Therapy Oncology Group(RTOG) grading standard of acute radiation injury. SPSS 17.0 statistical software was used for statistics. ResultsThe level of serum TGFβ1 preradiotherapy was 442.20-12 840.00 ng/L, the median and the quartile values were 677.5 ng/L and 2 186.7 ng/L. The levels of TGFβ1 postradiotherapy were 280.0-11 753.0 ng/L, median and quartile values were 605.0 ng/L and 1 172.6 ng/L, respectively(Z=-4.617, P=0.000). There were higher incidence of RP in male than female patients, smokers than nonsmokers, PTV>450 cm3 than≤450 cm3, radiotherapy period≤45 d than>45 d(P＜005), in patients with radiotherapy dose<60 Gy, and with increased levels of TGFβ1 after radiotherapy(P＜0.05). Patients with concurrent chemoradiotherapy, radiotherapy dose higher than 60 Gy, serum TGFβ1<677.5 ng/L preradiotherapy preferred to have better response rate(P＜005). Multivariate analysis showed that smoking, PTV>450 cm3, increased serum levels of TGFβ1 after chemotherapy were RP risk factors(P＜005). Patients with concurrent chemotherapy, radiotherapy dose≥60 Gy,  central lung cancer, serum TGFβ1 levels≤677.5 ng/L preradiotherapy had better efficacy(P＜005). ConclusionLower level of TGFβ1 before radiotherapy predicted a better prognosis. Patients with increased serum TGFβ1 levels after radiotherapy had more RP risks. Serum TGFβ1 levels could be considered as a predictor of NSCLC prognosis.

Key words: carcinoma, nonsmallcell lung, radiation pneumonia;   , transforming growth factor beta1