老年原发性肺癌患者血管内皮生长因子和细胞角化素蛋白与临床病理特征的关系

Changes of serum levels of vascular endothelial growth factors and CYFRA21-1 in elderly patients with primary lung cancer and their relationship with the clinical pathophysiological characteristics

目的评价老年原发性肺癌患者手术前后血清中血管内皮生长因子(VEGF)和细胞角化素蛋白片段19(CYFRA 21—1)的含量变化及其与肺癌临床病理特征的关系。方法分别用酶联免疫吸附实验(ELISA)法和电发光免疫法(ECLIA)测定54例老年原发性肺癌患者(肺癌组)术前和其中50例术后、34例老年肺良性疾病患者(非癌组)以及30例老年健康者(健康组)血清VEGF和CYFRA21—1含量变化,并分析它们与临床病理特征的关系。结果肺癌组患者手术前血清中VEGF含量(210．45±61．72)ng／L、CYFRA21—1含量(11．86±3．78)μg／L,均显著高于非癌组[(79．56±24．4)ng／L、(2．43±0．78)μg／L]和健康组[(71．81±19．32)ng／L、(2．14±0．65)μg／L],差异均有统计学意义(均为P<0．01)。非癌组血清VEGF和CYFRA21—1含量与健康组比较,差异无统计学意义(P>0.05)。肺癌组手术前血清VEGF和CYFRA21—1含量与肺癌原发肿瘤大小、细胞分化程度、临床TNM分期和有无远处转移密切相关(P<0．05),但与患者的性别、年龄、吸烟史、肿瘤部位及有无淋巴结转移无明显相关(P>0．05),血清VEGF含量与肺癌的组织学类型无关(P>0．05),而CYFRA21—1与组织学类型有关(P<0．01)。手术切除肿瘤后第7～10天,50例中有46例血清VEGF和CYFRA21—1含量下降,手术前后比较,差异有统计学意义(P<0．05),根治性切除患者血清vEGF和cYFRA21-1含量比姑息性切除患者下降幅度更明显(P<0．05)。结论老年原发性肺癌患者存在血清VEGF和CYFRA21—1含量升高,且与肺癌的部分临床病理特征有密切关系,可能是预测肺癌进展程度和判断预后的有用指标。

Objective To evaluate the relationship of the serum levels of vascular endothelial growth factors（VEGF） and CYFRA21-1 with the clinical pathophysiological characteristics in the elderly patients with primary lung cancer. Methods The serum VEGF level was measured by ELISA and serum CYFRA21-1 level was measured by electrochemiluminescence immunoassay （ECLIA）. The preoperative serum samples （54 patients）and postoperative serum samples （50 patients） from the elderly patients with primary lung cancer were taken. The 34 elderly patients with benign pulmonary diseases and 30 elderly healthy volunteers were enrolled as controls. Results The preoperative serum levels of VEGF and CYFRA21-1 were significantly higher in elderly patients with lung cancer than with benign pulmonary diseases and elderly healthy volunteers （P〈 0.01）. No significant difference was found in the levels of VEGF and CYFRA21-1 between patients with benign pulmonary diseases and healthy volunteers（P〉0.05）. The preoperative serum levels of VEGF and CYFRA21-1 in elderly patients with lung cancer were closely associated with the size of the primary tumors, TNM stages, grade of cell differentiation and distant metastasis （P〈0. 05）, but not with gender, age, smoking, type of the tumor and lymph node metastasis status （P〉0.05）. No correlation was found between the VEGF level and histologic classification of tumors （P 〉 0.05）. However, the serum CYFRA21-1 level was related to the histologic classification （P〈0. 01）. The serum levels of VEGF and CYFRA21-1 in elderly lung cancer patients were significantly lower on the 7 th and 10 th postoperative day than those before operation （P〈0. 05）. Conclusions Elevations of serum of levels VEGF and CYFRA21 1 exist in the elderly patients with lung cancer and are remarkably related with some biological characteristics of tumors. Preoperative and postoperative measurement of serum levels of VEGF and CYFRA21-1 are helpful for the diagnosis and prediction of prognosis in patients with lung cancer.