-
溶血磷脂酸(lysophosphatidic acid, LPA)又被称为多功能的“磷脂信使”, 它在多种重大的疾病, 尤其在肿瘤的发生和发展中起着重要作用。本研究通过检测不同组别肿瘤患者放疗前后血浆LPA水平的变化, 揭示放疗对LPA的影响, 从而进一步探讨血浆LPA水平与肿瘤放疗的预后及转归的关系。
-
脑转移肿瘤组及非脑肿瘤组的血浆LPA水平随放疗剂量的增加而逐渐降低, 即放疗60 Gy后 < 放疗40 Gy后 < 放疗前, 两组患者的LPA水平在三者间差异有统计学意义(F=21.230和F=40.884, P均 < 0.001)。原发性脑肿瘤组LPA水平随放疗剂量的增加亦逐渐降低, 即放疗60 Gy后 < 放疗40 Gy后 < 放疗前, 但LPA水平在三者间差异无统计学意义(F=1.980, P > 0.05)(表 1)。相关性分析显示: 脑转移肿瘤组及非脑肿瘤组LPA水平的变化与放疗剂量呈负相关(r=-0.410和r=-0.439, P均 < 0.05), 而原发性脑肿瘤组LPA水平的变化与放疗剂量无明显的相关性(r=-0.166, P > 0.05)。
例数 放疗前 放疗40 Gy后 放疗60 Gy后 脑转移肿瘤组 68 2.65 ± 0.46 2.49 ± 0.45 2.16 ±0-44 非脑肿瘤组 115 2.96 ± 0.73 2.57 ± 0.69 2.18 ±0.52 原发性脑肿瘤组 45 2.69 ± 0.48 2.54 ±0.51 2.48 ± 0.50 表 1 肿瘤患者放疗前后溶血磷脂酸水平比较 (
x±s , μmol/L))3组患者白细胞数及血小板数也随放疗剂量的增加而逐渐减少(表 2, 表 3)。但相关性分析显示: 非脑肿瘤组LPA水平的变化与白细胞及血小板数量的变化呈负相关(r=-0.285和r=-0.237, P均 < 0.05);而脑转移肿瘤组及原发性脑肿瘤组LPA水平的变化与白细胞数(r=0.111和r=0.052, P均 > 0.05)及血小板数(r=0.022和r=0.018, P均 > 0.05)的变化无明显相关性。
例数 放疗前 放疗40 Gy后 放疗60 Gy后 脑转移肿瘤组 68 6.78 ± 2.00 5.05 ± 2.23 4.95 ± 2.04 非脑肿瘤组 115 6.48 ± 1.97 5.18 ± 1.72 4.43 ± 2.00 原发性脑肿瘤组 45 6.56 ± 1.86 5.43 ± 1.87 4.87 ±2.30 表 2 肿瘤患者放疗前后白细胞数比较 (
x±s , ×109/L)例数 放疗前 放疗40 Gy后 放疗60 Gy后 脑转移肿瘤组 68 218.71 ±71.02 186.35 ±66.32 169.10 ±69.27 非脑肿瘤组 115 232.90 ±66.58 176.17 ±70.33 156.41 ±56.84 原发性脑肿瘤组 45 237.02 ± 69.07 186.49 ±76.42 162.04 ±61.52 表 3 肿瘤患者放疗前后血小板数比较 (
x±s , ×1012/L)放疗结束后1个月内复查颅脑CT和(或)MRI, 结果发现: 脑转移肿瘤组中肿瘤完全消失者7例、肿瘤体积缩小≥50%者56例、肿瘤变化不明显者5例; 非脑肿瘤组中肿瘤完全消失者32例、肿瘤体积缩小≥50%者68例、肿瘤变化不明显者15例; 原发性脑肿瘤组中肿瘤体积缩小≥50%者2例、肿瘤缩小不明显(≤25%)者43例。
肿瘤患者放疗前后血浆溶血磷脂酸水平变化的临床意义及相关性研究
Clinical significance and correlation of the level change of plasma lysophosphatidic acid in patients before and during radiotherapy
-
摘要:
目的 通过测定不同肿瘤患者放疗前后血浆溶血磷脂酸(LPA)水平的变化,探讨放疗对肿瘤患者血浆LPA的影响。 方法 将228例肿瘤患者分成3组,其中,第1组为脑转移肿瘤患者,第2组为非脑肿瘤患者,第3组为原发性脑肿瘤患者(设为对照组),所有患者均给予外照射,并于放疗前、放疗40 Gy后、放疗60 Gy后分别测定患者血浆LPA水平及白细胞和血小板计数,将结果进行统计学处理。 结果 脑转移肿瘤组及非脑肿瘤组LPA水平随照射剂量的增加而逐渐降低,即放疗60 Gy后 < 放疗40 Gy后 < 放疗前,且两组患者的LPA水平在三者间差异有统计学意义(F=21.230和F=40.884,P均 < 0.001);原发性脑肿瘤组LPA水平随照射剂量的增加亦逐渐降低,但LPA水平在三者间差异无统计学意义(F=1.980,P > 0.05),且瘤体变化不明显。脑转移肿瘤组和原发性脑肿瘤组的白细胞数及血小板数的变化虽也显示出随照射剂量的增加而逐渐减少的趋势,但其变化与LPA水平变化无明显相关性;而非脑肿瘤组LPA水平的变化与白细胞数和血小板数的变化呈负相关(r=-0.285和r=-0.237,P均 < 0.05)。 结论 在脑转移肿瘤及体部肿瘤患者中,LPA水平的变化与放疗剂量呈负相关,LPA水平可作为肿瘤患者放疗疗效的预测指标。 Abstract:Objective To investigate the effects of radiotherapy on the level of lysophosphatidic acid(LPA)in different patients. Methods Three groups of patients(metastatic brain tumor group, non-brain tumor group and primary brain tumor group)were given external irradiation(by linear accelerator).LPA level, white blood cell count and platelet count in the blood plasma were evaluated pre-irradiation and after irradiation with 40 Gy and 60 Gy respectively. Results The LPA level decreased gradually as irradiation doses increase in metastatic brain tumor group non-brain tumor group(after irradiation with 60 Gy < after irradiation with 40 Gy < pre-irradiation).There was significant statistical difference between them(F=21.230, P < 0.001; F=40.884, P < 0.001).In primary brain tumor group, the level of LPA also decreased gradually, but with no significant statistical difference(F=1.980, P > 0.05), and neoplasm volume changed little.White blood cell count and platelet count gradually decreased with the increasing irradiation doses in metastatic brain tumor group and primary brain tumor group, but there was no significant correlation to LPA level.However, there was a negative correlation to LPA level in non-brain tumor group(r=-0.285 and r=-0.237, both P < 0.05). Conclusions There is a negative correlation between radiotherapy dose and LPA level in metastatic brain tumor patients and non-brain tumor patients.LPA level could be used as a predictor of the effect of the radiotherapy in tumor treatment. -
Key words:
- Neoplasms /
- Lysopholipids /
- Radiotherapy
-
表 1 肿瘤患者放疗前后溶血磷脂酸水平比较 (
x±s , μmol/L))例数 放疗前 放疗40 Gy后 放疗60 Gy后 脑转移肿瘤组 68 2.65 ± 0.46 2.49 ± 0.45 2.16 ±0-44 非脑肿瘤组 115 2.96 ± 0.73 2.57 ± 0.69 2.18 ±0.52 原发性脑肿瘤组 45 2.69 ± 0.48 2.54 ±0.51 2.48 ± 0.50 表 2 肿瘤患者放疗前后白细胞数比较 (
x±s , ×109/L)例数 放疗前 放疗40 Gy后 放疗60 Gy后 脑转移肿瘤组 68 6.78 ± 2.00 5.05 ± 2.23 4.95 ± 2.04 非脑肿瘤组 115 6.48 ± 1.97 5.18 ± 1.72 4.43 ± 2.00 原发性脑肿瘤组 45 6.56 ± 1.86 5.43 ± 1.87 4.87 ±2.30 表 3 肿瘤患者放疗前后血小板数比较 (
x±s , ×1012/L)例数 放疗前 放疗40 Gy后 放疗60 Gy后 脑转移肿瘤组 68 218.71 ±71.02 186.35 ±66.32 169.10 ±69.27 非脑肿瘤组 115 232.90 ±66.58 176.17 ±70.33 156.41 ±56.84 原发性脑肿瘤组 45 237.02 ± 69.07 186.49 ±76.42 162.04 ±61.52 -
[1] Niesporek S, Denkert C, Weichert W, et al. Expression of lysophosphatidic acid acyltransferase beta(LPAAT-beta)in ovarian carcinoma: correlation with tumour grading and prognosis. Br J Cancer, 2005, 92(9): 1729-1736. doi: 10.1038/sj.bjc.6602528 [2] Jonkers J, Moolenaar WH. Mammary tumorigenesis through LPA receptor signaling. Cancer Cell, 2009, 15(6): 457-459. doi: 10.1016/j.ccr.2009.05.003 [3] Yu S, Murph MM, Lu Y, et al. Lysophosphatidic acid receptorsdetermine tumorigenicity and aggressiveness of ovarian cancer cells. J Natl Cancer Inst, 2008, 100(22): 1630-1642. doi: 10.1093/jnci/djn378 [4] Ren J, Xiao YJ, Singh LS, et al. Lysophosphatitic acid is constitutively produced by human peritoneal mesothelial cells and enhances adhsion, migration, and invasion of ovarian cancer cells. Cancer Res, 2006, 66(6): 3006-3014. doi: 10.1158/0008-5472.CAN-05-1292 [5] Shida D, Kitayama J, Yamaguchi H, et al. Lysophosphatidic acid transactivates both c-Met and epidermal growth factor receptor, and induces cyclooxygenase-2 expression in human colon cancer LoVo cells. World J Gastroenterol, 2005, 11(36): 5638-5643. doi: 10.3748/wjg.v11.i36.5638 [6] 徐文生, 黄艳丽, 蒙玉刚, 等. 卵巢恶性上皮性肿瘤血浆溶血磷脂酸与CA125诊断价值的对比观察. 中华肿瘤防治杂志, 2008, 15(11): 840-842. doi: 10.3969/j.issn.1673-5269.2008.11.012
[7] Sutphen R, Xu Y, Wilbanks GD, et al. Lysophospholipids are potential biomarkers of ovarion cancer. Cancer Epidemiol Biomarkers Prev, 2004, 13(7): 1185-1191. [8] 肖焕擎, 杨洁, 孙政, 等. 溶血磷脂酸在胃恶性上皮性肿瘤患者中表达及意义. 临床和实验医学杂志, 2008, 7(1): 75-76. doi: 10.3969/j.issn.1671-4695.2008.01.048