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癌症化疗患者唾液炎症介质与口腔黏膜炎的相关性。

Association between salivary inflammatory mediators and oral mucositis in patients with cancer undergoing chemotherapy.

机构信息

Department of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, 192-0392, Japan.

Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

出版信息

Support Care Cancer. 2024 Sep 2;32(9):625. doi: 10.1007/s00520-024-08836-1.

Abstract

PURPOSE

Oral mucositis is a severe adverse event in patients undergoing chemotherapy and radiotherapy that may lead to the termination of cancer treatment. This study aimed to elucidate the relationship between salivary inflammatory mediators and oral mucositis in patients undergoing chemotherapy.

METHODS

This prospective cohort study included 167 patients who underwent chemotherapy at our institution between June 2020 and November 2023. We evaluated the association between chemotherapy-induced oral mucositis and salivary inflammatory mediators using multiple comparison tests and logistic regression analyses.

RESULTS

Of the 167 patients, 67 (40.1%) had oral mucositis. Dunn's multiple comparison test revealed that interleukin-6 was significantly higher in oral mucositis of grades 2 and ≥ 3 (P < 0.01) and tumor necrosis factor (TNF)-α was significantly higher in oral mucositis of grades 3-4 (P < 0.01). Logistic regression analysis showed that the risk of oral mucositis was significantly higher for tumor necrosis factor (TNF)-α > 4.4 pg/mL than for TNF-α ≤ 4.4 pg/mL (adjusted odds ratio, 2.4; 95% confidence interval, 1.1-5.3; P = 0.03).

CONCLUSION

Saliva is useful in evaluating inflammation in patients with chemotherapy-induced oral mucositis. Furthermore, TNF-α may be a predictive marker for the severity of oral mucositis in patients undergoing chemotherapy.

摘要

目的

口腔黏膜炎是接受化疗和放疗的患者的一种严重不良反应,可能导致癌症治疗的终止。本研究旨在阐明化疗患者唾液炎症介质与口腔黏膜炎之间的关系。

方法

本前瞻性队列研究纳入了 2020 年 6 月至 2023 年 11 月期间在我院接受化疗的 167 例患者。我们使用多重比较检验和逻辑回归分析评估了化疗引起的口腔黏膜炎与唾液炎症介质之间的关系。

结果

在 167 例患者中,有 67 例(40.1%)发生了口腔黏膜炎。Dunn 多重比较检验显示,2 级和≥3 级口腔黏膜炎的白细胞介素-6 显著升高(P<0.01),3-4 级口腔黏膜炎的肿瘤坏死因子(TNF)-α显著升高(P<0.01)。逻辑回归分析显示,TNF-α>4.4pg/mL 患者发生口腔黏膜炎的风险明显高于 TNF-α≤4.4pg/mL 患者(调整后的优势比,2.4;95%置信区间,1.1-5.3;P=0.03)。

结论

唾液可用于评估化疗引起的口腔黏膜炎患者的炎症情况。此外,TNF-α可能是预测化疗患者口腔黏膜炎严重程度的标志物。

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