肺癌患者血管内皮生长因子和内皮抑素水平变化及意义

Changes of serum levels of VEGF and endostatin in lung cancer patients and their significance

目的探讨肺癌患者手术、化疗及联合恩度化疗前后血清血管内皮生长因子(VEGF)和E内皮抑素(ndostatin)水平的变化及临床意义。方法用ELISA法检测20例健康人及20例肺癌患者手术前后和60例肺癌患者化疗及联合恩度前后的血清VEGF和Endostatin水平。结果肺癌组血清VEGF、Endostatin水平明显高于健康人组(P<0.01),其水平与肿瘤大小、临床分期有关,与组织学类型无关(P>0.05)。肺癌患者手术后第1天VEGF水平高于手术前(P<0.01),第7天血清VEGF水平高于手术前和手术后第1天水平(P<0.01)。肺癌患者单独化疗受益组结束后1 d血清内皮抑素水平明显高于化疗前和化疗结束后14 d的水平(P<0.05)。单独化疗无效组第14天血清VEGF水平高于化疗前和化疗后第1天水平(P<0.05)。肺癌患者单独及联合"恩度"化疗受益组治疗后第1天血清VEGF水平低于化疗前(P<0.05),第14天血清VEGF水平低于治疗前和治疗后第1天水平(P<0.05)。联合恩度化疗有效率为56.67%,单独化疗有效率为26.67%(P<0.05),且其有效患者的VEGF水平治疗后明显下降(P<0.05)。结论肺癌患者的血清VEGF和Endostatin水平升高且随临床分期进展和肿瘤直径增大明显升高,并与手术及化疗有关,有助于对肺癌患者的治疗效果和预后进行判断。血清VEGF和Endostatin水平不受病理类型的影响,化疗联合"恩度"治疗肺癌优于单用化疗,血清VEGF水平是疗效监测指标之一。

Objective To evaluate the change of serum VEGF and endostatin （ES） levels in lung cancer patients before and after operation, chemotherapy alone or with ＂Endostar＂ and their clinical significance. Methods Serum VEGF and ES levels were detected and compared in 20 normal control persons and 80 patients with lung cancer by enzyme linked immunosorbant assay （ELISA）. Results Serum VEGF and ES levels in lung cancer group were significantly higher than those in control groups （P〈0.01）. Serum VEGF and ES levels were closely related to tumor size and clinical stage of tumors, but not related to the histological classification （P 〉 0.05）. Serum VEGF levels in lung cancer patients on Day 1 post-operation were significantly higher than these before operation （P〈 0.01）, and the VEGF levels on day 7 post-operation were significantly higher than those before operation and on day 1 post-operation（ P 〈 0.01）. Serum ES levels in patients who had effective response to chemotherapy alone on the Day 1 post-chemotherapy were significantly higher than those before chemotherapy and on Day 14 post-chemotherapy（P 〈 0.05）. Serum VEGF levels in patients who had ineffective response to chemotherapy alone on Day 14 were signifi- cantly higher than those before chemotherapy and on Day 1 post-chemotherapy（P 〈 0.05）. Serum VEGF levels in patients who had effective response to chemotherapy alone or with ＂Endostar＂ on Day 1 post-chemotherapy were significantly lower than those before Chemotherapy（P〈0.05）, and the VEGF levels on Day 14 post-treatment were significantly lower than those before treatment and on Day 1 post-treatment （P〈0.05）. The effective rate was 56.67% in the treatment group, and 26.67 % in the control group, The VEGF levels in CR and PR patients of the treatment group were significantly lower than those in the control group after treatment（P 〈 0.05）. Conclusion The increased serum levels of VEGF and ES were associated with tumor size, clinical stage of tumors, operation and chemotherapy in lung cancer patients. This is useful for treatment and prognostic judgement of lung cancer patients. Serum VEGF and ES levels were not related to the histological classification. Chemotherapy combined Endostar is superior to chemotherapy alone in the treatment of Lung neoplasms. VEGF, as a biomarker, may be useful in predicting the efficacy of the combined treatment.