肺癌患者血浆肾上腺髓质素与VEGF的相关性及其临床意义

Correlation between adrenomedullin and VEGF in plasma of patients with lung cancer and the clinical significance

目的研究肾上腺髓质素（ADM）与血管内皮生长因子（VEGF）在肺癌患者中的表达、相关性及其临床意义，探讨ADM在肺癌中潜在的临床应用价值。方法应用放射免疫分析法检测66例肺癌患者组、31例良性肺疾病组及16名健康者组血浆中ADM及VEGF表达水平。结果ADM及VEGF血浆水平在肺癌组显著高于良性肺疾病组和健康组（P〈0．05），ADM血浆水平在良性肺疾病组显著高于健康组（P〈0．05），而VEGF血浆水平在良性肺疾病组与健康组差异无统计学意义（P〉0．05）；肺癌组远处转移者ADM及VEGF血浆水平显著高于局部淋巴结转移者（P〈0．05），局部淋巴结转移者显著高于无淋巴结转移者（P〈0．05）。ADM及VEGF血浆水平与局部淋巴结转移、远处转移及TNM分期相关，而且随肿瘤分期增加ADM及VGEF血浆水平递增（P〈0．05）。肺癌组ADM与VEGF表达存在显著正相关（r=0．449，P〈0．01）。结论ADM与VEGF在肺癌血管形成过程中具有协同作用；检测血浆ADM、VEGF血浆水平可能有助于肺癌与良性肺疾病的诊断及鉴别诊断，可能有助于肺癌临床分期；干预ADM及其信号传导通路可能成为肺癌靶向治疗的新途径。

Objective To investigate the expression of adrenomedullin（ADM） and vascular endothelial growth factor（VEGF） in ptasm of patients with lung cancer, their correlation, and clinical significance. To explore the potential value of ADM for lung cancer in clinic. Methods The levels of plasms ADM and VEGF were measured by means of radioimmunoassay in 66 cases of lung cancer, 31 cases of benign lung disease and 16 cases of healthy persons. Results The expression levels of plasm ADM and VEGF were significantly higher in the patients with lung caner than those in benign lung disease and healthy persons （P 〈 0. 05 ）, ADM in benign lung disease was significantly higher than that in the healthy persons （P 〈 0. 05 ）, while VEGF in benign lung disease and healthy persons had no significant difference （P 〉 0. 05 ）. The levels of plasm ADM and VEGF in distant metastasis was significantly higher than those with local lymph node metastasis （ P 〈 0. 05 ）, local lymph node metastasis was significantly higher than those without lymph node metastasis（ P 〈 0. 05 ）. The levels of plasm ADM and VEGF were closely related to the local lymph node metastasis, distant metastasis and TNM staging. Furthermore, the expression levels of plasm ADM and VEGF increase with the clinical stage （ P 〈 0. 05 ）. There was a significantly positive correlation between ADM and VEGF in patients with lung cancer（r = 0. 449, P 〈0. 01 ）, but there was any correlation between benign lung disease group and healthy group （P 〉 0. 05 ）. Conclusion ADM and VEGF have synergistic effects in the process of neovascularization in lung cancer; to detect the expression of ADM, VEGF in plasm may be helpful for diagnosis of lung cancer and benign lung, lung cancer clinical staging, to interfere with ADM and its signal transduction pathway may be another new targeted therapy of lung cancer.