放射性肺炎(RP)是肺癌放疗中常见且严重的并发症,其发病机制复杂,涉及炎症反应、氧化应激及纤维化等多种 病理过程。 近年来,分子标志物在放射性肺炎的早期诊断、风险预测及治疗效果评估中的研究取得了显著进展。 炎症因子如 转化生长因子-β1(TGF-β1)、白介素-6(IL-6)及急性期反应蛋白如血清淀粉样蛋白 A( SAA)在放射性肺炎的早期炎症反应 中具有重要作用。 同时,细胞外基质蛋白生腱蛋白 C(TNC)和趋化因子 CC 趋化因子配体 18 等分子主要参与纤维化阶段的 病理进程,提示其在晚期肺损伤中的潜在价值。 此外,免疫相关因子如 C 反应蛋白(CRP)和 CD4 + / CD8 +比值被认为能够反映 放射性肺损伤(RILI)的全身炎症状态及宿主免疫功能的变化。 尽管这些分子标志物在早期诊断和预后评估中展现出良好的 前景,其特异度和敏感度仍需通过大规模临床研究进一步验证。 本综述系统总结了当前放射性肺炎相关分子标志物的研究 进展,分析其临床应用价值及局限性,并展望未来研究方向,如多组学技术整合和个体化风险预测模型的开发,以期为放射性 肺炎的精准管理和靶向治疗提供新的理论依据。

Radiation pneumonitis is a common and severe complication of radiotherapy for lung cancer with complex pathogenesis involving inflammation oxidative stress and fibrosis. In recent years molecular biomarkers have made significant advances in the early diagnosis risk prediction and therapeutic evaluation of radiation pneumonitis. Studies have found that inflammatory factors such as transforming growth factor-β1 TGF-β1 interleukin-6 IL-6 and acute-phase proteins like serum amyloid A SAA play crucial roles in the early inflammatory response of radiation pneumonitis. Meanwhile extracellular matrix proteins such as tenascin C TNC and chemokines like CCL18 are mainly involved in the fibrotic phase of lung damage indicating their potential value in late- stage injury. Additionally immune - related factors including C - reactive protein CRP and the CD4 + / CD8 + ratio are considered reflective of systemic inflammation and immune dysfunction in radiation-induced lung injury. Although these biomarkers show promise for the early diagnosis and prognosis of radiation pneumonitis their specificity and sensitivity require further validation through large-scale clinical studies. This review systematically summarizes the current progress in radiation pneumonitis-associated molecular biomarkers analyzes their clinical significance and limitations and explores future research directions such as integrating multi-omics technologies and developing personalized risk prediction models to provide new insights into the precision management and targeted treatment of radiation pneumonitis.