| Objective:To detect the concentration of serum cystatin C,and discuss the monitoring role of cystatin C for renal demage of elder cancer patients during adjuvant chemotherapy after operation.Methods:For124elder cancer patients and288healthy controls.to detect the levels of Cys C、serum creatine(Scr)and blood urea nitrogen(BUN)、calculate the creatine clearance(Ccr) by Cockcroft-Gault equation.Then analyze the correlation between Cys C and aging.also analyze the correlation between Cys C、Scr、BUN and Ccr, and whether there are differences for Cys C、Scr、BUN and Ccr before and after adjuvant chemotherapy.Futher more.whether there are also differences for Cys C Scr、 BUN and Ccr in elder patients who receiving platinum-containing protocols and no-platinum-containing protocols.Results:(1)Cys C is good correlation with aging, they showed a significant correlation.The Correlation coefficient is0.56(P<0.01).Cys C expressed increasedly in older people who are more than65years old, especially75years of age or older,(2)There are no differences for Cys C、Scr、BUN and Ccr in elder cancer patients before and after2cycles of adjuvant chemotherapy(P=0.11,P=0.86,P=0.64,P=0.23respectively).But after4cycles of adjuvant chemotherapy, Cys C increased(P=0.01) and Ccr decreased(P=0.027) compared with that of before adjuvant chemotherapy,whereas there are no differences for Scr and BUN(P=0.07,P=0.068).(3)Subgroup analyzes:there are no differences for Cys C、Scr、BUN and Ccr in elder cancer patients before and after2cycles of adjuvant chemotherapy for those not receiving platinum-containing protocols(p=0.44,p=0.32,p=0.46, p=0.20respectively).And there are also no differences for them after4cycles of adjuvant chemotherapy(p=0.14,p=0.30,p=0.093. p=0.27respectively).For those receiving platinum-containing protocols, there are no differences for Cys C、Sci、 BUN and Ccr before and after2cycles of adjuvant chemotherapy(p=0.15,p=0.37,p=0.54, p=0.34respectively).;but after4cycles of adjuvant chemotherapy,Cys C and Ccr change obviously(P=0.003,0.037),Scr and BUN don’t change(P=0.087,0.12).(4)There were20elder cancer patients whose Cys C levels were above the normal range(>1.09mg/L) after2cycle of adjuvant chemotherapy.when the expression levels of Scr, BUN, Ccr were within the normal range (P were0.14,0.07,0.14).Then continue to given them adjuvant chemotherapy, Cys C levels significantly increased (P=0.007) and Ccr decreased significantly compared with the previous (P=0.009),and their Ccr levels were all less than<75ml/min/1.73m2, Scr and BUN also significantly higher than before (P=0.015,0.023).(5)There were good correlation between Cys C,Scr,BUN and Ccr(health group: r=-0.78,-0.41,-0.27;chemotherapy group:r=-0.82,-0.49,-0.25),and the correlation between Cys C and Ccr was the best one.Conclusion:(1)For elder cancer patients before and after adjuvant chemotherapy,Cys C was a sensitive marker of renal function.even more convenient and practical than Ccr.It’s an alternative methods to Ccr in monitoring chemotherapy drug-induced renal dysfunction,and thereby guide the adjustment of the chemotherapy drugs.(2)When the level of Cys C in elder cancer patients was above the normal range during adjuvant chemotherapy,we should reduce the dose of chemotherapy drugs.to avoid aggravating renal dysfunction futher more.(3)Platinums were the major chemotherapy drugs that cause renal dysfunction in elderly cancer patients with posterative adjuvant chemotherapy.so we need to monitor renal function closely in the application of palatinum-based adjuvant chemotherapy.(4)Elderly cancer patients had a good tolerance with non-platinum-based chemotherapy.and their renal function didn’t change significantly in the process of posterative adjuvant chemotherapy. |
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