鼻咽癌放射治疗前测定血管内皮生长因子的意义

Significance of serum vascular endothelial growth factor test before radiotherapy in patients with nasopharyngeal carcinoma

目的:于放疗前后检测鼻咽癌患者血清中血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)和β2微球蛋白的水平,探讨其变化及临床意义。方法:采集58例鼻咽癌患者和24名健康体检者血清,应用酶联免疫吸附法(enzyme-linkedimmunosorbentassay,ELISA)测定VEGF水平,用时间分辨荧光免疫分析(time-resolvedfluoroimmunoassay,TRFIA)方法测定β2微球蛋白水平,并对其变化及其与临床分期和患者生存期的关系进行分析。结果:鼻咽癌患者治疗前血清VEGF水平为(174.0±130.0)ng/L,稍高于健康体检者的(134.1±66.6)ng/L,但差异无统计学意义(P>0.05)。鼻咽癌TNM分期T4和临床分期Ⅳa患者治疗前血清VEGF水平较高。治疗前血清VEGF水平>267.3ng/L者,无远处转移生存期短(P<0.05)。β2微球蛋白水平高的患者,中位生存期短,但差异无统计学意义。结论:鼻咽癌治疗前VEGF水平明显升高提示预后不良。

Objective： To study the changes of serum vascular endothelial growth factor （VEGF） and beta2-microglobulin levels before and after radiotherapy in 58 patients with nasopharyngeal carcinoma （NPC）,and to elucidate the clinical significance of VEGF and beta 2-microglobulin test before radiotherapy. Methods,Serum VEGF level was measured by sandwich ELISA in 58 patients with NPC and 24 healthy individuals, and the serum beta 2-microglobulin was assayed with time-resolved fluoroimmunoassay. Results, The serum VEGF level in patients with NPC was （ 174.0 ± 130.0） ng/L, higher than （ 134. 1 ± 66.6） ng/L of the healthy subjects, but the difference was not significant （P〈0.05）. The serum VEGF level was higher in T4 and Ⅳ a patients with NPC. No significant differences in the levels of serum VEGF were found among various N classifications in the patients with NPC. Patients with the serum VEGF level higher than 267.3 ng/L （mean＋2 s of the serum VEGF level in the healthy individuals） had a shorter metastasis-free survival time （P〈0. 05）.Although the patients with high beta 2-microglobulin level had a shorter survival time, the difference was not significant. Conclusion： The NPC patients with high serum VEGF level have a poor prognosis.