血清VEGF表达水平与不能手术非小细胞肺癌同期放化疗相关性研究

Correlation of serum vascular endothelial growth factor with inoperable non-small cell lung cancer treated with concurrent chemoradiotherapy

目的 检测不能手术的非小细胞肺癌（NSCLC）患者在同期放化疗前后血清VEGF（sVEGF）水平,探讨其变化规律与病理生理特征、疗效及预后相关性.方法 采用ELISA双抗体夹心法定量检测50例不能手术NSCLC患者同期放化疗前后sVEGF表达水平,同时检测75例健康人群sVEGF水平.治疗前患者与健康对照比较采用成组t检验,治疗前后比较采用配对t检验.结果 患者治疗前sVEGF水平均显著高于对照组,分别为（241.09±52.45）ng/L和（103.72±39.22）ng/L（t=2.50,P＜0.05）.治疗前sVEGF表达水平与原发灶大小、远处转移、细胞分化及临床分期有关（t=9.61～14.94,P值均＜0.05）,与原发部位、淋巴结转移、组织学类型、年龄及吸烟史均无关（t=0.58～1.84,P值均＞0.05）.治疗前VEGF水平显著高于治疗后水平,分别为（241.09±52.45）ng/L和（133.64±33.62）ng/L（t=12.20,P＜0.01）.治疗后sVEGF平均水平与治疗前比较,完全缓解组均显著降低（92.35 ±37.48）ng/L（t=3.79,P＜0.01）,进展组降低不明显（276.32±47.98）ng/L（t=1.32,P＞0.05）,而部分缓解组和无变化组介于两者之间（113.10±39.20）ng/L（t=13.58,P＜0.01）和（198.10±42.68）ng/L（t=4.78,P＜0.05）.结论 同期放化疗前后sVEGF表达水平与不能手术NSCLC的发生发展、远处转移、细胞分化和临床分期等密切相关,其表达水平的变化是预测不能手术NSCLC生物学行为的有效指标,可为疗效和预后判断提供实验依据.

Objective To investigate the correlation among expression of serum VEGF without operation between pre-and post-chemoradiotherapy in non-small cell lung cancer （NSCLC） patients, to explore the correlation of markers on prognosis and effect. Methods The serum vascular endothelial growth factor （VEGF） were detected in 50 patients without operation between pre-and post-chemoradiotherapy with NSCLC by ELISA method. The group t-test was played into before concurrent chemoradiotherapy and normal control. The paired t-test was played into before and after concurrent chemoradiotherapy. Results The prechemoradiotherapy serum VEGF （ 241.09 ± 52.45 ） ng/L in NSCLC patients was significantly higher than those in normal control patients （103.72 ± 39. 22） ng/L （t = 2. 50,P ＜0. 05 ）. The pre-chemoradiotherapy serum VEGF in NSCLC patients was closely related to pTNM stage, distant metastasis, grade of cell differentiation and the size of the primary tumors （ t = 9. 61 - 14. 94, all P ＜ 0. 05 ）, but not to the histological classification, type of the tumor, lymph node status, age, gender of the patients or smoking or not （t =0. 58 - 1.84, all P ＞ 0. 05 ）. The pre-chemoradiotherapy serum VEGF （ 24 1.09 ± 52. 45 ） ng/L was significantly higher than that of the post-chemoradiotherapy （ 133.64 ± 33.62） ng/L （ t = 12. 20, P ＜ 0. 01 ）. The post-chemoradiotherapy serum VEGF decreases to the pre-was the biggest in the CR patients （（ 92.35 ± 37.48ng/L） ,t =3.79,P ＜0. 01 ） ,the smallest in the PA patients （ （276.32 ±47.98） ng/L,t = 1.32,P ＞0. 05） ） ,and bigger in the PR patients and the NC patientspatients （ （ 113.10 ± 39. 20） ng/L,t = 13.58,P ＜0. 01 and （ 198.10 ± 42.68 ） ng/L, t = 4. 78, P ＜ 0. 05 ） ）, respectively. Conclusions Elevation of serum VEGF exists in patients with NSCLC . The serum VEGF in patients with NSCLC might be helpful to evaluate the biological behavior of lung cancer. Detection of VEGF expression maybe helpful for predicting the prognosis of NSCLC patients.