直肠癌同步放化疗所致葡萄糖代谢状态与急性放射性肠炎之间存在显著相关性。

Significant correlation between glucose metabolism status and acute radiation enteritis resulting from concurrent chemoradiotherapy in rectal cancer.

作者信息

Gao Yuan, Meng Lingjun

机构信息

Tongji University School of Medicine Shanghai 200092, China.

Department of Oncology, Shanghai East Hospital, Tongji University School of Medicine Shanghai 200120, China.

出版信息

Am J Transl Res. 2023 Jun 15;15(6):4228-4236. eCollection 2023.

PMID:37434838

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10331679/

Abstract

OBJECTIVE

To explore the relationship between glucose metabolism and acute radiation enteritis from chemoradiotherapy for rectal cancer.

METHODS

In this retrospective study, the clinical data of 75 rectal cancer patients who received concurrent chemoradiotherapy in Binzhou Second People's Hospital from February 2019 to February 2022 were collected and analyzed. According to the Radiation Therapy Oncology Group (RTOG)/European Organization for Research on Treatment of Cancer (EORTC) radiation response grading criteria, the patients were classified into four groups with different glucose metabolism statuses: NGR (normal glucose regulation) group, IFG (impaired fasting glucose) group, IGT (impaired glucose tolerance) group, and DM (diabetes mellitus) group. Two-factor logistic regression was used to analyze whether IFG, IGT, or DM were risk factors for acute radiation enteritis.

RESULTS

(1) The fasting plasma glucose (FPG, F=20.550, < 0.001), 2-hour post-meal blood glucose (2hPG, F=14.920, < 0.001), triglycerides (TG, F=3.355, =0.024), high-density lipoprotein cholesterol (HDL-C) (F=4.109, =0.010), low-density lipoprotein cholesterol (LDL-C, F=4.545, =0.006), and systolic blood pressure (SBP, F=5.398, =0.002) differed greatly among the NGR group, IFG group, IGT group, and DM group, all < 0.05. (2) The incidence of acute radiation enteritis was 34.67% in the 75 patients, and in DM patients it was higher than in the NGR, IFG, or IGT patients (χ=14.702, =0.002). (3) There were significant differences in BMI (F=3.594, =0.044) and DBP (F=3.954, =0.033) among the asymptomatic group, mild group, and severe group ( < 0.05). (4) Body mass index (BMI) was positively correlated with acute radiation enteritis in IFG, IGT, and DM patients (=1.361, =0.020). (5) DM was positively correlated with acute radiation enteritis (=6.167, =0.039).

CONCLUSIONS

DM was significantly correlated with acute radiation enteritis induced by concurrent chemoradiotherapy for rectal cancer, while IFG and IGT were not.

摘要

目的

探讨直肠癌放化疗中糖代谢与急性放射性肠炎之间的关系。

方法

本回顾性研究收集并分析了2019年2月至2022年2月在滨州市第二人民医院接受同步放化疗的75例直肠癌患者的临床资料。根据放射治疗肿瘤学组（RTOG）/欧洲癌症研究与治疗组织（EORTC）的放射反应分级标准，将患者分为具有不同糖代谢状态的四组：正常血糖调节（NGR）组、空腹血糖受损（IFG）组、糖耐量受损（IGT）组和糖尿病（DM）组。采用双因素逻辑回归分析IFG、IGT或DM是否为急性放射性肠炎的危险因素。

结果

（1）NGR组、IFG组、IGT组和DM组之间的空腹血糖（FPG，F = 20.550，P < 0.001）、餐后2小时血糖（2hPG，F = 14.920，P < 0.001）、甘油三酯（TG，F = 3.355，P = 0.024）、高密度脂蛋白胆固醇（HDL-C）（F = 4.109，P = 0.010）、低密度脂蛋白胆固醇（LDL-C，F = 4.545，P = 0.006）和收缩压（SBP，F = 5.398，P = 0.002）差异均有统计学意义，均P < 0.05。（2）75例患者中急性放射性肠炎的发生率为34.67%，DM患者的发生率高于NGR、IFG或IGT患者（χ² = 14.702，P = 0.002）。（3）无症状组、轻度组和重度组之间的BMI（F = 3.594，P = 0.044）和舒张压（DBP，F = 3.954，P = 0.033）差异有统计学意义（P < 0.05）。（4）IFG、IGT和DM患者的体重指数（BMI）与急性放射性肠炎呈正相关（β = 1.361，P = 0.020）。（5）DM与急性放射性肠炎呈正相关（β = 6.167，P = 0.039）。