Larsen A, Hovdenak N, Karlsdottir A, Wentzel-Larsen T, Dahl O, Fagerhol M K
Department of Oncology, Haukeland University Hospital, NO-5021 Bergen, Norway.
Scand J Gastroenterol. 2004 Nov;39(11):1113-8. doi: 10.1080/00365520410003614.
Non-invasive diagnostic tools to evaluate the severity of acute, radiation-induced proctitis are not readily available. The faecal excretion of eight markers of gut inflammation was therefore examined. Five proteins and three lipid derivates were analysed in sequential stool samples taken before and during radiation therapy.
Stool samples from 15 patients with prostate cancer scheduled for radiation therapy were examined. Pretreatment and in-treatment samples (2nd and 6th weeks) were measured by enzyme-linked immunosorbent assay (ELISA) (calprotectin, lactoferrin, transferrin, leukotriene B4, prostaglandin E2, thromboxane B2 and TNF alpha) or nephelometry (alpha 1-antitrypsin).
Calprotectin and lactoferrin concentrations increased significantly during radiation treatment (P = 0.0005 and P = 0.019). Transferrin was detected in only 9 out of 45 samples. There were no changes in tumour necrosis factor alpha (TNF alpha), leukotriene B4, prostaglandin E2 and thromboxane B2 during treatment. alpha 1-antitrypsin could not be detected in any sample.
This study indicates that faecal calprotectin and lactoferrin concentrations could be markers of acute, radiation-induced proctitis. Patient compliance and stability of the markers make this a promising method for clinical research. Eicosanoids could be measured in stool samples, but the concentrations did not increase with increasing radiation dose.
用于评估急性放射性直肠炎严重程度的非侵入性诊断工具尚不完善。因此，对肠道炎症的八项标志物的粪便排泄情况进行了检查。在放射治疗前和治疗期间采集的连续粪便样本中，分析了五种蛋白质和三种脂质衍生物。
对15例计划接受放射治疗的前列腺癌患者的粪便样本进行了检查。通过酶联免疫吸附测定（ELISA）（钙卫蛋白、乳铁蛋白、转铁蛋白、白三烯B4、前列腺素E2、血栓素B2和肿瘤坏死因子α）或比浊法（α1-抗胰蛋白酶）测量治疗前和治疗期间（第2周和第6周）的样本。
放射治疗期间钙卫蛋白和乳铁蛋白浓度显著升高（P = 0.0005和P = 0.019）。在45个样本中，仅9个检测到转铁蛋白。治疗期间肿瘤坏死因子α（TNFα）、白三烯B4、前列腺素E2和血栓素B2无变化。任何样本中均未检测到α1-抗胰蛋白酶。
本研究表明，粪便钙卫蛋白和乳铁蛋白浓度可能是急性放射性直肠炎的标志物。患者的依从性和标志物的稳定性使这成为一种有前景的临床研究方法。可以在粪便样本中测量类花生酸，但浓度并未随放射剂量增加而升高。
