The early predictive value of serum LTB4 and HSP70 for radiation-induced pneumonia in NSCLC patients after radiotherapy

Abstract:Objective To explore the early predictive value of serum leukotriene B4(LTB4) and heat shock protein 70(HSP70) for radiation pneumonia(RP) in NSCLC patients after radiotherapy. Methods From September 2021 to September 2024, 108 patients with NSCLC were selected from the Department of Radiology, Third Medical Center of PLA General Hospital. ELISA method was used to measure serum LTB4 and HSP70. The correlation between serum LTB4, HSP70 and RP grading in RP was analyzed using Spearman's method. ROC curve was used to analyze the predictive efficacy of serum LTB4 and HSP70 for RP in NSCLC. Logistic regression was used to analyze the influencing factors of RP in NSCLC. Results For the non RP group, the RP group had prominently higher serum LTB4 and HSP70(t=7.693, 8.067, all P<0.001). The serum levels of LTB4 and HSP70 in RP patients were lower than grade 2 and grade 3 and grade 4(F=9.071, 8.067, all P<0.001). Serum LTB4 and HSP70 in RP patients were positively correlated with RP grading(r_s=0.584, 0.662, P<0.05). High serum LTB4 and HSP70 are the risk factors of RP in NSCLC patients(P<0.01). The AUC of serum LTB4, HSP70 and their combination in predicting the occurrence of RP in patients with NSCLC were 0.823[OR(95%CI)=0.738-0.890], 0.850[OR(95%CI)=0.769-0.912]and 0.959[OR(95%CI)=0.902-0.987], respectively, and their combined prediction efficiency was better than their own(Z/P=3.048/0.002, 2.316/0.021). Conclusion Serum LTB4 and HSP70 are upregulated in NSCLC patients with RP after radiotherapy, and the joint detection of serum LTB4 and HSP70 has a higher predictive power for RP in NSCLC patients.