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目的:通过测定恶性肿瘤化疗患者化疗前后血清中血清胱抑素C(cystatin C,Cys C)的表达水平,分析和探讨其在评价肾功能中的作用和地位。方法:110例晚期恶性肿瘤患者,检测其化疗前后血清中血清肌酐(serum creatinine,Scr)、Cys C和内生肌酐清除率(creatinine clearance,Ccr)等指标;分析Cys C表达水平与患者性别、年龄及体能状况评分的关系;接受含铂与非含铂化疗方案患者血清中Cys C和Ccr的表达水平在化疗前后是否存在差异,以及治疗后肾功能轻度受损患者(Ccr50~75mL/min)的Cys C表达水平在化疗前后是否存在差异。结果:Cys C的表达水平在不同年龄组(≥70岁和<70岁)患者中存在差异(P=0.04),而在性别和体能状态评分中,差异无统计学意义;接受含铂方案化疗患者的Cys C和Ccr表达水平,在化疗前后存在差异(P=0.00和0.00),而在接受非含铂方案化疗的患者中差异无统计学意义(P=0.07和0.45);肾功能轻度受损患者的Cys C表达水平化疗前后差异有统计学意义(P=0.03)。结论:在<70岁以下的恶性肿瘤患者中,检测Cys C可以与Ccr一样监测化疗后患者早期肾功能损害的情况,而对于Ccr轻度下降的患者,检测Cys C的表达水平较检测Scr更灵敏,因此Cys C可以作为替代Ccr对患者肾功能进行评估的可靠指标。
OBJECTIVE: To determine the serum cystatin C (Cys C) expression levels in patients with malignant tumor before and after chemotherapy and analyze its role and status in the evaluation of renal function. Methods: Serum levels of serum creatinine (Scr), Cys C and creatinine clearance (Ccr) in 110 patients with advanced malignant tumor were measured before and after chemotherapy. The levels of Cys C, Age and physical status scores. The serum levels of Cys C and Ccr in patients receiving platinum-based and non-platinum-containing chemotherapy were significantly different before and after chemotherapy, and those with mild renal dysfunction after treatment (Ccr50 ~ 75mL / min ) Cys C expression levels before and after chemotherapy there is a difference. Results: There was a significant difference in the expression level of Cys C between different age groups (≥70 years and <70 years) (P = 0.04), but there was no significant difference in gender and fitness score. The levels of Cys C and Ccr were not significantly different between before and after chemotherapy (P = 0.00 and 0.00), but not between those treated with non-platinum regimen (P = 0.07 and 0.45), mild renal function The level of Cys C expression in the injured patients was significantly different between before and after chemotherapy (P = 0.03). CONCLUSIONS: In patients with malignant tumors <70 years of age, detection of Cys C can be as effective as Ccr in monitoring early renal impairment in patients with chemotherapy, whereas in patients with mild Ccr decline, detection of Cys C expression is more frequent than with Scr Therefore, Cys C can be used as a reliable indicator of renal function in patients with Ccr replacement.