VEGF mRNA作为ITC标志物在骨肉瘤结合辅助化疗保肢治疗中的临床应用

Clinical application of VEGF mRNA as a marker for ITC in the salvagetherapy combined with neoadjuvant chemotherapy in patients with osteosarcoma

目的探讨外周血中血管内皮生长因子(VEGF)mRNA作为游离癌细胞(ITC)标志物在骨肉瘤保肢手术结合辅助化疗中的临床应用价值。方法27例骨肉瘤保肢手术结合辅助化疗的患者为研究对象(A组),另设同时期转移癌组(B组,8例)、良性骨软骨瘤组(C组,10例)和正常对照组(D组,10例)。FQ-PCR定量检测各组化疗前及术前外周血中VEGFmRNA的表达情况及A组VEGFmRNA在整个围手术期的动态变化情况。结果A组化疗前的VEGFmRNA表达阳性率为74.1%、B组术前为100.0%,明显高于C组术前的10.0%和D组的0%。A组围手术期VEGFmRNA的阳性表达呈波动性变化。结论VEGFmRNA是具有较好特异性和敏感性的骨肉瘤ITC的标志物,围手术期其水平的动态监测对骨肉瘤保肢结合辅助化疗治疗具有重要的临床意义。

Objective To investigate the clinical value of using vascular endothelial growth factor（VEGF）mRNA in the peripheral blood as marker for isolated tumor cells（ITC）for patients with osteosarcoma underwent the salvagetherapy combined with neoadjuvant chemotherapy.MethodsTwenty-seven patients with osteosarcoma underwent the salvagetherapy combined with neoadjuvant chemotherapy were collected in our hospital as group A.Ten patients with metastatic carcinoma as group B,10 cases with benign osteochondroma as group C and 10 healthy volunteers as group D.Fluorescent quantitative-PCR）was used to detect the specificity of VEGF mRNA expression in osteosarcoma patients and its perioperative dynamic changes in group A.Results The positive rate of VEGF mRNA before chemical therapy was 74.1% in group A and 100% before operation in group B,which were significantly higher than 10.0% in group C before operation and 0% in group D.The changes of VEGF mRNA were fluctuated perioperatively in group A.Conclusion VEGF mRNA in peripheral blood as marker of ITC in osteosarcoma has high specificity and sensitivity.Dynamically monitoring the perioperative changes of VEGF mRNA is of importance for guiding chemical therapy in the patients with osteosarcoma.