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2021 年第 3 期 第 16 卷

血浆转化生长因子β1水平在预测肺癌患者放疗后近期疗效中的作用及相关机制分析

The role of plasma transforming growth factor-β1 level in predicting the short-term efficacy of radiotherapy in patients with lung cancer and its related mechanisms

作者:葛飞1黄向东1路杰2

英文作者:Ge Fei1 Huang Xiangdong1 Lu Jie2

单位:1甘肃省庆阳市人民医院胸心外科745000;2甘肃省庆阳市镇原县中医院普外科744500

英文单位:1Department of Cardiothoracic Surgery Qingyang People′s Hospital Gansu Province Qingyang 745000 China; 2Department of General Surgery Zhenyuan County Traditional Chinese Medicine Hospital Gansu Province Qingyang 744500 China

关键词:肺癌;放疗;转化生长因子β1;淋巴细胞亚群;磷脂酰肌醇-3-激酶-蛋白激酶B-哺乳动物雷帕霉素靶蛋白通路

英文关键词:Lungcancer;Radiotherapy;Transforminggrowthfactor-β1;Lymphocytesubsets;Phosphatidylinositol3-kinase-protenkinaseB-mammaliantargetofrapamycinpathway

  • 摘要:
  • 目的 探讨血浆转化生长因子β1(TGF-β1)水平在预测肺癌患者放疗后近期疗效中的作用及相关机制。方法 选取20166月至20176月在甘肃省庆阳市人民医院接受胸部调强放疗的肺癌患者78例。分别于放疗前、放疗2周和4周、放疗结束后6周采集血液标本检测血浆TGF-β1和外周血淋巴细胞亚群水平以及磷脂酰肌醇-3-激酶(PI3K)-蛋白激酶B(Akt)-哺乳动物雷帕霉素靶蛋白(mTOR)通路相关蛋白表达情况。分析放疗前后血浆TGF-β1水平与疗效的关系;分析放疗期间血浆TGF-β1与外周血淋巴细胞亚群水平的相关性。结果 放疗24周和放疗结束后6周,治疗有效者TGF-β1水平均明显低于治疗无效者(均P0.05)。放疗24周和放疗结束后6周患者血浆TGF-β1水平与同时点CD+4细胞和CD+4/CD+8比值均呈明显负相关,与CD+8细胞均呈明显正相关(均P0.01)。放疗4周和放疗结束后6周磷酸化mTORp-mTOR)蛋白相对表达量分别为(3.25±0.72)、(1.76±0.54),磷酸化Aktp-Akt)蛋白相对表达量分别为(1.95±0.64)、(1.02±0.38),均明显低于放疗前和放疗2周[p-mTOR:(5.91±1.15)、(6.14±1.80),p-Akt:(8.36±1.47)、(7.51±1.13)](均P0.05)。结论 肺癌患者放疗后TGF-β1水平降低者近期疗效较好;其机制可能为TGF-β1水平降低通过提升T淋巴细胞水平来抑制Akt/mTOR磷酸化,降低PI3K-Akt-mTOR信号通路活性,增强机体抗肿瘤免疫反应。

  • Objective To investigate the role of plasma transforming growth factor-β1(TGF-β1) level in predicting the short-term efficacy of radiotherapy in lung cancer patients and its related mechanism. Methods From June 2016 to June 2017, 78 patients with lung cancer who received chest intensity-modulated radiotherapy in Qingyang Peoples Hospital, Gansu Province were prospectively selected. Blood samples were collected before radiotherapy, 2 and 4 weeks after radiotherapy, and 6 weeks after completion of radiotherapy to detect the levels of plasma TGF-β1 and peripheral blood lymphocyte subsets, and the expressions of phosphatidylinositol 3-kinase (PI3K)-proten kinase B(AKT)-mammalian target of rapamycin(mTOR) pathway related proteins. The relationship between the level of plasma TGF-β1 and the curative effect before and after radiotherapy was analyzed; the correlation between plasma TGF-β1 and peripheral blood lymphocyte subsets levels during radiotherapy was analyzed. Results At 2 and 4 weeks after radiotherapy and 6 weeks after completion of radiotherapy, the levels of TGF-β1 in patients with effective treatment were significantly lower than those in patients with ineffective treatment (all P0.05). At 2 and 4 weeks after radiotherapy and 6 weeks after completion of radiotherapy, the levels of plasma TGF-β1 were negatively correlated with CD+4 cells and the ratio of CD+4/CD+8 at the same time points, but positively correlated with CD+8 cells (all P0.01). At 4 weeks after radiotherapy and 6 weeks after completion of radiotherapy, the relative expression levels of phosphorylated(p)-mTOR and p-Akt were 3.25±0.72,1.76±0.54 and 1.95±0.641.02±0.38, respectively. Those were significantly lower than those before and 2 weeks after radiotherapyp-mTOR:(5.91±1.156.14±1.80;p-Akt:(8.36±1.477.51±1.13)](all P0.05Conclusions The short-term curative effect of patients with lung cancer is better when the level of TGF-β1 decreases after radiotherapy. The mechanism may be that the decrease of TGF-β1 level can increase the level of T lymphocyte, inhibit the phosphorylation of Akt/mTOR, reduce the activity of PI3K-Akt-mTOR signaling pathway and enhance the bodys anti-tumor immune response.

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