CAJ | 학술논문

目的：研究放疗前后血清TNF-α、TGF-β1及 T淋巴细胞亚群水平与急性放射性肺病的关系。方法收集食管癌和非小细胞肺癌患者60例，采用ELISA法检测放疗前后血清TNF-α、TGF-β1水平，采用流式细胞术检测放疗前后T细胞亚群水平，并评价它们与急性放射性肺病之间的关系。结果（1）放疗后患者血清 TNF-α水平升高，但高损伤组（放射性肺病≥2级）与低损伤组（放射性肺病＜2级）TNF-α水平无统计学差异。（2）放疗结束时和放疗结束后3个月高损伤组TGF-β1水平显著高于低损伤组[（13.06±5.24）ng/ml vs.（9.14±4.93）ng/ml，P=0.009；（10.88±4.95） ng/ml vs.（7.02±3.42）ng/ml，P=0.008]。（3）放疗结束时和放疗结束3个月高损伤组总T细胞水平显著低于低损伤组[（56.12±9.88）% vs.（66.88±14.27）%， P=0.007；（59.88±10.02）% vs.（66.98±10.21）%，P=0.019]，但CD4+和CD8+T细胞水平均未显现出统计学差异。（4）放疗结束时和放疗结束后3个月高损伤组 CD4+CD25+T 细胞水平显著高于低损伤组[（17.81±3.87）% vs.（14.51±5.19）%，P=0.022；（16.39±3.78）%vs.（13.05±3.61）%，P=0.003]。（5）CD4+CD25+T细胞水平与TGF-β1水平之间存在一定的正相关性。结论放疗后TGF-β1升高、总T细胞降低及CD4+CD25+T细胞水平升高者，发生放射性肺损伤较明显，且TGF-β1与CD4+CD25+T细胞水平之间存在一定的正相关性。
목적：연구방료전후혈청TNF-α、TGF-β1급 T림파세포아군수평여급성방사성폐병적관계。방법수집식관암화비소세포폐암환자60례，채용ELISA법검측방료전후혈청TNF-α、TGF-β1수평，채용류식세포술검측방료전후T세포아군수평，병평개타문여급성방사성폐병지간적관계。결과（1）방료후환자혈청 TNF-α수평승고，단고손상조（방사성폐병≥2급）여저손상조（방사성폐병＜2급）TNF-α수평무통계학차이。（2）방료결속시화방료결속후3개월고손상조TGF-β1수평현저고우저손상조[（13.06±5.24）ng/ml vs.（9.14±4.93）ng/ml，P=0.009；（10.88±4.95） ng/ml vs.（7.02±3.42）ng/ml，P=0.008]。（3）방료결속시화방료결속3개월고손상조총T세포수평현저저우저손상조[（56.12±9.88）% vs.（66.88±14.27）%， P=0.007；（59.88±10.02）% vs.（66.98±10.21）%，P=0.019]，단CD4+화CD8+T세포수평균미현현출통계학차이。（4）방료결속시화방료결속후3개월고손상조 CD4+CD25+T 세포수평현저고우저손상조[（17.81±3.87）% vs.（14.51±5.19）%，P=0.022；（16.39±3.78）%vs.（13.05±3.61）%，P=0.003]。（5）CD4+CD25+T세포수평여TGF-β1수평지간존재일정적정상관성。결론방료후TGF-β1승고、총T세포강저급CD4+CD25+T세포수평승고자，발생방사성폐손상교명현，차TGF-β1여CD4+CD25+T세포수평지간존재일정적정상관성。
Objective To detect the levels of serum TNF-α, TGF-β1 and T lymphocyte subsets before and after radiotherapy and evaluate their clinical relevance in radiation pneumopathy (RP). Methods 60 patients with esophageal cancer or non-small cell lung cancer were collected in Lianyungang NO.2 Hospital from November, 2011 to July, 2012. Serum levels of TNF-α and TGF-β1 were detected by enzyme linked immunosorbent assay (ELISA) and the proportion of T lymphocyte subsets was analyzed by flow cytometry (FCM) before and after radiotherapy. The relationship between them and RP was analyzed. Results (1)TNF-α levels were increased after radiotherapy, but there was no significant differences between RP group (RP grade≥2) and non-RP group (RP grade<2). (2)TGF-β1 levels in RP group were significantly higher than that in non-RP group at the end of radiotherapy and 3 months after radiotherapy, (13.06±5.24)ng/ml vs. (9.14±4.93)ng/ml, P=0.009; (10.88±4.95)ng/ml vs. (7.02±3.42)ng/ml, P=0.008.(3)The proportion of T lymphocytes in RP group was significantly lower than that in non-RP group at the end of radiotherapy and 3 months after radiotherapy, (56.12±9.88)% vs. (66.88±14.27)%, P=0.007;(59.88±10.02)%vs. (66.98±10.21)%, P=0.019, but there was no significant differences in the proportion of CD4+T cells and CD8+T cells. (4)The proportion of CD4+CD25+T cells in RP group was significantly higher than that in non-RP group at the end of radiotherapy and 3 months after radiotherapy, (17.81±3.87)%vs. (14.51±5.19)%, P=0.022;(16.39±3.78)%vs. (13.05±3.61)%, P=0.003. (5)There was a positive correlation between TGF-β1 level and the proportion of CD4+CD25+T cells. Conclusion The serum level of TGF-β1 and the proportion of T lymphocytes and CD4+CD25+T cells could identify patients at risk for RP. There is a positive correlation between TGF-β1 level and the proportion of CD4+CD25+T cells.