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目的:探讨接受放疗的非小细胞肺癌(NSCLC)患者血清中肺表面活性蛋白A(PS-A)水平的动态变化与放射性肺炎(RP)发生的关系。方法:对68例接受三维适形放疗的Ⅲ期肺癌患者采用酶联免疫吸附法(ELISA)检测于放疗前、放疗剂量达40～50 Gy时及放疗后4周血清中PS-A水平。结果:25例患者发生RP。RP者中放疗前PS-A为(38.6±20.8)ng/mL,放疗中升高达(51.4±19.3)ng/mL(P<0.05),放疗后PS-A高于放疗前[(78.2±21.5)ng/mL;P<0.05]。在无RP者中放疗前PS-A与放疗中、后均相似(P>0.05)。RP者与无RP者中放疗前PS-A相似(P>0.05),放疗中及放疗后前者PS-A明显高于后者(P<0.05)。结论:PS-A水平变化与RP发生密切相关,动态监测其变化可早期预测RP发生,可作为急性放射性肺损伤易感性指标。
Objective: To investigate the relationship between the dynamic changes of serum surfactant protein A (PS-A) levels and the occurrence of radiation pneumonia (RP) in patients with non-small cell lung cancer (NSCLC) receiving radiotherapy. Methods: Serum levels of PS-A in patients with stage Ⅲ lung cancer undergoing three-dimensional conformal radiotherapy were measured by enzyme-linked immunosorbent assay (ELISA) before radiotherapy, at doses of 40-50 Gy and 4 weeks after radiotherapy. Results: Twenty-five patients developed RP. The mean PS-A in patients with radiotherapy was (38.6 ± 20.8) ng / mL before radiotherapy and 51.4 ± 19.3 ng / mL in radiotherapy (P <0.05) ) ng / mL; P <0.05]. PS-A was similar to radiotherapy before and after radiotherapy in those without RP (P> 0.05). The levels of PS-A in patients with RP before and after radiotherapy were significantly higher than those before radiotherapy (P <0.05). CONCLUSIONS: The change of PS-A level is closely related to the occurrence of RP. The dynamic change of PS-A can predict the occurrence of RP early, which can be used as an index of susceptibility to acute radiation-induced lung injury.