TGF-β1 in serum and induced sputum for predicting radiation pneumonitis in patients with non-small cell lung cancer after radiotherapy
- VernacularTitle:诱导痰及血清TGF-β1水平对非小细胞肺癌急性放射性肺炎的预测价值
- Author:
Wang JING
1
;
Qiao XUE-YING
;
Lu FU-HE
;
Zhou ZHI-GUO
;
Song YU-ZHI
;
Huo JUN-JIE
;
Liu XIN
Author Information
1. 河北医科大学第四医院
- Keywords:
Non-small cell lung cancer;
three-dimensionalconformal radiotherapy;
radiation pneumonitis;
transforming growth factor-β1;
induced sputum
- From:Chinese Journal of Cancer
2010;29(3):353-358
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective:Research has confirmed that transforming growth factor-β1(TGF-β1)is one of the cytokines related to radiation pneumonitis.But the level of TGF-β1 in serum needed to predict radiation pneumonitis is still not clear.This study assessed the value of TGFβ1 in both serum and induced sputum in predicting radiation pneumonitis,providing a reference for the radiotherapy of patients with non-small cell lung cancer(NSCLC).Methods:A total of 23 patients with NSCLC treated with three-dimensional conformal radiotherapy(3D-CRT)or intensity-modulated radiation therapy(JMRT)in our department between November 2007 and January 2009 were analyzed and evaluated.TGF-β1 levels in both serum and sputum were detected before and near the end of radiotherapy for all the patients.The TGF-β1 level in serum was measured with enzyme-linked immunosorbent assay(ELISA).Immunocytochemistry assays were used to detect TGF-β1 expression in sputum sediment.Radiation pneumonitis was graded according to Radiation Therapy Oncology Group(RTOG)radiation scoring criteria every 3 weeks frOm the start to 3 months after the end of treatment.Results:Radiation pneumonitis was noted in 9 patients in this cohort.The total incidence of radiation pneumonitis was 39.1%(9/23)and those with Grade Ⅱ or worse was 30.4%(7/23).The absolute TGF-β1 level in serum after radiotherapy was higher than before radiotherapy,but there was no statisticaI difference(P=0.139).Patients with increased levels of TGF-β1 had a higher incidence of radiation pneumonitis(45.5%)than those with decreased TGF-β1 levels post-radiotherapy(40.0%).Though there was a tendency of higher incidence of radiation pneumonitis with increases in TGFβ1 level,no statistical difference was found(P=1.000).Patients with tumor response had higher incidence of radiation pneumonitis(50.0%)than patients without when TGF-β1 levels in serum increased,but there was no statistical difference(P=0.792).TGF-β1 was positively expressed(brown yellow)in sputum on immunocytochemistry assays and located in the cytoplasm of either macrophages or epithelial cells.Macrophages were the main cells expressing TGF-β1.A significantly higher positive expression rate (71.4%)was found in sputum post-radiotherapy than pre-radiotherapy (28.6%)(P=0.015).The higher incidence of radiation pneumonitis (46.7%)was found in patients with positive TGF-β1 expression in sputum post-radiotherapy than those with negative expression post-radiotherapy(14.3%)(P=0.193).Conclusions:It may be more reasonable to predict radiation pneumonitis by combining the change of TGF-β1 levels in serum with tumor response than just the change of TGFβ1 levels in serum alone.TGF-β1 can positively express in the sputum of patients with NSCLC.located in macrophages and epithelial cells,with macrophages as the main areas of expression.Patients with positively expressed TGF-β1 in sputum after radiotherapy have a higher incidence of radiation pneumonitis than those with negative expressions.The positive expression of TGF-β1 in sputum is expected to become a factor for predicting radiation pneumonitis.
