肺癌患者体液免疫状态与放疗效果的临床分析

Clinical analysis of humoral immune state and radiation therapeutic efficacy in lung cancer patients

关键词:  非小细胞肺癌  三维适形放射治疗  补体

Key words:  NSCLC  three conformal radiotherapy  complement

摘要:

［目的］ 约70%肺癌患者接受放射治疗，本文拟通过对非小细胞肺癌患者放疗前体液免疫功能状态与疗效的分析，探讨其对放射治疗的影响。［方法］　用自动生化分析仪测定血清球蛋白、IgG、IgA、IgM及 补体3(C3)、补体4(C4)的量。所有患者均采取三维适形放射治疗，总剂量Dt＝60 Gy。放疗前和放疗后一个月行胸部CT检查，用P3MD计划系统计算肿瘤体积。瘤体缩小50％以上定为治疗有效。［结果］ 42例患者33例有效，9例无效（3例无变化）；血清IgG、IgA、IgM、C3及C4的量有效组分别为11.77±2.58、 2.44±0.93、 0.97±0.46、 1.23±0.32和0.32±0.09(g/L); 无效组分别为11.94±5.06、2.58±1.28、1.24±0.42、0.89±0.22和0.24±0.05(g/L)。C3和C4有效组明显高于无效组（P＜0.01和P＜0.05）。将瘤体缩小的百分率与IgG、IgA、IgM、C3及C4行相关分析得出的r值分别为-0.04、-0.17、-0.316、0.50和0.54，C3和C4与其有明显的正相关性（P＜0.001）。［结论］ 肺癌患者放射治疗前血清中补体水平与肿瘤的治疗效果有明显的相关性，放疗前充分了解血清中C3和C4量，对评估放射治疗效果有一定的帮助。 关键词：非小细胞肺癌；三维适形放射治疗；补体

Abstract:

［Objective］ About 70% lung cancer patients need radiotherapy. Exploring the affection of humoral immune status by analysis on the radiation therapeutic effect and in non- small cell lung cancer patients. Methods Determine the IgG，IgA，IgM and C3,C4 with auto biochemical analysis instrument. All patients were treated by the Three Dimension Conformal Radiotherapy with total dose 60 Gy. Lung CT was donebefore and 1 month after radiotherapy. The tumor gross volumes were calculated with the P3MD plan system. In efficiency groups, the tumor volume decreased more than 50%. ［Result］ Efficiency case were 33, un-efficiency case were 9 in 42 patients. In efficiency groups, serum IgG，IgA，IgM，C3 and C4 were 11.77±2.58，2.44±0.93，0.97±0.46， 1.23±0.32 and 0.32±0.09(g/L); un-efficiency groups, 11.94±5.06，2.58±1.28，1.24±0.42，0.89±0.22 and 0.24±0.05(g/L) respectively. C3 and C4 in efficiency groups were more than those un-efficiency groups（P＜0.01 and P＜0.05）. By the correlation analysis between tumor diminution percent and IgG,IgA,IgM,C3 and C4, the r value were -0.04，-0.17，-0.316，0.50 and 0.54 respectively. C3 and C4 had definitely positive correlation（P＜0.001）.［Conclusion］　The correlation between humoral immune state and the local control rate of tumoris obvious in lung cancer patients. Before the radiotherapy, the sufficient research of C3 andC4 values in serum helps the assessment to the radiotherapy efficacy.