肺癌患者外周血循环内皮细胞和VEGF检测临床意义的探讨

Clinical significance of measuring peripheral circulating endothelial cells and VEGF in patients with lung cancer

目的:探讨肺癌患者外周血循环内皮细胞(CECs)包括活性循环内皮细胞(aCECs)与VEGF之间的关系及其在肺癌中的临床意义。方法:用流式细胞仪对70例肺癌患者(NSCLC64例)化疗前后及30例健康人外周血CECs及aCECs进行检测,同时采用ELISA方法检测肺癌患者化疗前后VEGF水平。结果:NSCLC患者外周血CECs及aCECs的数量明显高于健康人群(P=0.000)。不同病理类型肺癌之间CECs及aCECs的数量差异无统计学意义(NSCLC与SCLC,P=0.878、0.936;鳞癌与腺癌,P=0.786、0.658)。CECs及aCECs的数量与VEGF之间无明显相关性(P=0.697、0.631)。治疗后不同疗效间肺癌患者VEGF水平比较,PD均高于CR+PR及SD(P=0.009、0.031)。NSCLC及SCLC化疗后aCECs的数量高于化疗前(P=0.031、0.029);SD及PD患者CECs、aCECs的数量高于化疗前(P=0.024、0.014;P=0.036、0.028);对治疗后不同疗效肺癌患者CECs及aCECs水平比较,aCECs数量PD、SD均高于CR+PR(P=0.022、0.009)。结论:VEGF联合CECs及aCECs检测可以作为很好的预测性指标评估肺癌的血管生成状况及判断预后。

OBJECTIVE： To study the relationship of the amount of peripheral circulating endothelial cells（CECs） including activated circulating endothelial cells（aCECs） and the serum level of vascular endothelial growth factor（VEGF） in patients with lung cancer,and their clinical significance.METHODS： CECs and aCECs were enumerated in 70 lung cancer patients（64 NSCLC） and 30 healthy controls by flow cytometry.The serum level of VEGF in lung cancer patients was determined by ELISA method.RESULTS： The count of CECs and aCECs in NSCLC patients was significantly higher than that in healthy controls（P=0.000）.The significant difference of CECs and aCECs in pathology types were not detected（NSCLC vs SCLC,P were 0.878 and 0.936 and SC vs AC,P were 0.786 and 0.658）,and correlation between the CECs,aCECs count and the serum level of VEGF in NSCLC patients（P were 0.697 and 0.631）.VEGF values were higher in PD patients than in patients with CR＋PR and SD（P were 0.009 and 0.031）.The aCECs count were significantly increased by chemotherapy as compared with pretreatment in NSCLC and SCLC patients（P were 0.031 and 0.029）.CECs and aCECs were increased as compared with pretreatment in SD and PD patients（P were 0.024 and 0.014;P were 0.036 and 0.028）.The aCECs count were higher in SD and PD patients than that in patients with CR＋PR（P were 0.022 and 0.009）.CONCLUSION： CECs and aCECs combing with VEGF may be suggested to be surrogate biomarkers of angiogenesis and prognosis in lung cancer.