晚期肺癌患者化疗前后血浆转化生长因子β1水平变化

Changes of plasma transforming growth factor-β1 in patients with advanced lung cancer treated by chemotherapy

目的：探讨晚期肺癌患者化疗前后血浆转化生长因子β1（TGF-β1）水平变化及其临床意义。方法：采用ELISA法检测37例肺癌患者化疗前、第1周期化疗后、第2周期化疗后及23例健康者血浆TGF-β1水平。结果：肺癌患者化疗前血浆TGF-β1水平明显高于正常对照组（Z＝3．581，P＜0．001）。肺癌患者不同年龄、性别、病理类型、临床分期组间比较，血浆TGF-β1水平差异无统计学意义。肺癌患者化疗2周期后，进展组血浆TGF-β1水平明显升高（t ＝3．067，P＝0．018）；部分缓解组、稳定组血浆TGF-β1水平无明显变化（P＞0．05）。第2周期化疗后，以120．85 ng/L为临界值，血浆TGF-β1水平用于预测疗效的灵敏度为85．71％，特异度为63．64％[AUC（95％CI）＝0．711（05．34～0．875）]。第2周期化疗后，以157．28 ng/L为临界值，血浆TGF-β1水平用于预测病情变化的灵敏度、特异度分别可达81．50％、82．76％[AUC（95％CI）＝0．875（0．737～1．013）]。结论：血浆TGF-β1水平可以对化疗疗效及病情变化起到一定预测作用。

Aim：To access the changes of plasma level of transforming growth factor-β1 （ TGF-β1 ） in patients with advanced lung cancer treated by chemotherapy .Methods：The plasma level of TGF-β1 was measured by enzyme-linked im-munosorbent assay （ELISA） in 37 patients with advanced lung cancer and 23 healthy control subjects.Results：The plas-ma level of TGF-β1 in patients with advanced lung cancer was significantly higher compared with normal subjects （ Z=3.581,P＆lt;0.001）.No association was observed between plasma TGF -β1 levels and various clinicopathological factors in-cluding age ,gender , histology and TNM staging .After 2 cycles chemotherapy , plasma TGF-β1 levels significantly in-creased in group PD （t=3.067,P=0.018）; No significant change was observed in SD group （t=0.488,P=0.634）. Early prediction of disease progression was achieved with a sensitivity 85.71%and specificity 63.64%for plasma TGF-β1 level after 2nd cycle [area under the ROC curve =0.711（0.534-0.875）].Similarly sensitivity and specificity for plasma TGF-β1level after 2nd cycle were observed[area under the ROC curve=0.875（0.737-1.013）],sensitivity=81.50%, specificity=82.76%.Conc lusion：The level of plasma TGF-β1 could be a guide to predict the response of chemotherapy and disease progression in patients with lung cancer .