胰腺癌调强放疗对Cystatin C分泌的影响

摘要

Objective To observe the change of the serum level change of Cystatin C in the patients of pancreatic carcinoma before and after the intensity-modulated radiotherapy, and to explore the relationship between the change of concentration of Cystatin C and the radiation doze of the two kidneys. Methods 21 pancreatic carcinoma patients were enrolled, each patient was given simultaneouse chemotherapy with Gemcitabline, the change of Cystatin before and after the radiotherapy measured. Regression analysis was applied to Cystain concentration and the DVH index of the radiation dose on kidney. [mediam 0.52mg/L;range (0.17~1.00) mg/L](P<0.05).The index of the kidney in the 8 patients whose elevated serum Cystatin C level above 1.03mg/L over the normal threshold was not significantly different to those 13 cases whose Cystatin C levels were not elevated(P>0.05). The correlated analysis showed:the serum level of Cystatin C was only correlated to Dmax(Gy)(P=0.032). Conclusions The Cystatin C concentraton was significally higher than those without radiology, which is only related to the Dmax of the radiation dose of kidney, but is not related to the other kidney indice.%目的：评价胰腺癌调强放疗前后胰腺癌患者血清半胱氨酸蛋白酶抑制剂C（Cystatin C）的变化，并对血清中Cystatin C浓度的改变与双侧肾脏的受照射剂量之间的关系进行研究。方法共纳入21例胰腺癌患者，每位患者给予包括吉西他滨的同步放化疗治疗，放疗前和放疗后测定血清Cystatin C变化。对于Cystatin C升高患者的Cystatin C浓度和肾脏照射剂量的DVH参数进行回归分析。结果21例行放疗的胰腺癌患者中，有8例Cystatin C升高；整组患者与照射前比较，放疗后患者血清中的Cystatin C[中位0.74mg/L；范围（0.22-3.12）mg/L]明显高于放疗前[中位0.52mg/L；范围(0.17~1.00）mg/L]（P<0.05）。在8例血清Cystatin C升高超过正常上线1.03mg/L患者的肾脏的剂量参数均与Cystatin C未升高13例患者组的无明显差异（P>0.05）；相关性分析表明：其血清中的Cystatin C浓度与仅与Dmax（Gy）（P=0.032）有相关性。结论胰腺癌放疗的Cystatin C浓度明显高于未受照射者，仅与肾脏受照射剂量的Dmax相关，而与其他肾脏剂量参数指标无相关关系。