非小细胞肺癌高龄患者三维适形放疗前后血清VEGF TGF-β1水平的测定及临床意义

Clinical Significance of Serum VEGF and TGF-β1 by Detecting Their Expression Level before and after Three-dimensional Conformal Radiation Therapy in Elder Patients with Non-small Cell Lung Cancer

目的:通过测定不可手术非小细胞肺癌(NSCLC)高龄患者三维适形放疗(3D-CRT)前、后血清中VEGF和TGF-β1的表达水平及变化,探讨两者在病情监测中的临床意义。方法:46例NSCLC高龄患者3D-CRT前采用酶联免疫法(ELISA)测定血清VEGF和TGF-β1的表达水平,然后行重复定位缩野3D-CRT,放疗结束后3周再次测定血清VEGF和TGF-β1的表达水平,并行胸部CT检查,根据CT结果分为放疗有效组(CR+PR)和无效组(SD+PD)。结果:全部患者均完成治疗,期间未接受化疗,CR 8例(17.4%),PR 26例(56.5%),SD 9例(19.6%),PD 3例(6.5%),总有效率73.9%。VEGF在有效组(CR+PR)的表达水平为(163.72±19.46)pg/mL,在无效组(SD+PD)的表达水平为(169.35±17.98)pg/mL,放疗后有效组表达水平明显下降,而无效组表达水平不但未下降,反而明显升高,差异均有统计学意义(t=16.57、19.60,P<0.05)。TGF-β1在有效组(CR+PR)的表达水平为(43.52±4.89)pg/mL,在无效组(SD+PD)的表达水平为(49.63±5.12)Pg/mL,放疗后有效组表达水平明显下降,而无效组表达水平不但未下降,反而明显升高,差异均有统计学意义(t=30.52、27.33,P<0.05)。结论:NSCLC高龄患者3D-CRT前后血清中VEGF和TGF-β1的表达水平可为疗效判断提供依据。

Objective： To explore the clinical significance of the serums VEGF and TGF-β1 by detecting their expression level before and after a three-dimensional conformal radiation therapy （ 3D-CRT ） in elder patients with non-small cell lung cancer （ NSCLC ）. Methods： Forty-six cases were enrolled in the current study. The expression level of serum VEGF and TGF-β1 was detected by the enzyme-linked immunosorbent assay method before and after 3D-CRT of repetitive reduced fields. All cases were separated into valid （CR＋PR） and invalid （ SD＋PD ） groups according to the result of the chest CT. T Test was used for statistical analysis. Results： All cases were able to complete radiotherapy, and the complete remission （ CR ） rate was 17.4%, whereas the partial remission （ PR ） rate was 56.5%. The stable disease （ SD ） rate was 19.6%, and the progression disease （ PD ） rate was 6.5%. The overall response （ CR ＋ PR ） rate was 73.9%. The expression levels of VEGF in the valid and invalid groups were （ 163.72 ± 19.46 ） pg/mL and （ 169.35 ± 17.98 ） pg/mL, respectively. The expression level in valid group significantly decreased after radiotherapy, whereas that in （ invalid group significantly increased. A significant difference between the two groups was observed （ t = 16.57, 19.60, P 〈0.05 ）. On the other hand, the expression levels of TGF-β1 in the valid and invalid groups were （ 43.52 ± 4.89 ） pg/mL and （ 49.63 ± 5.12 ） pg/mL, respectively. The expression level in the valid group significantly decreased after radiotherapy, whereas that in the invalid group significantly increased. A significant difference between the two groups was found （ t= 30.52, 27.33, P 〈 0.05 ）. Conclusion： The expression level of serum VEGF and TGF-D 1 may provide the basis for the therapeutic effect in elder patients with NSCLC undergoing 3D-CRT.