血清VEGF，SCC-Ag和CYFRA21-1对中晚期肺鳞癌化疗疗效评估的价值

Value of Serum VEGF,SCC-Ag and CYFRA2 1-1 for Predicting Eesponse to Chemotherapy in Advanced Lung Squamous Cell Carcinoma

目的：探讨联合检测中晚期肺鳞癌患者血清血管内皮生长因子（VEGF）、鳞状细胞癌抗原（SCC-Ag）和细胞角蛋白19片段（CYFRA21-1）在化疗疗效评估中的价值。方法对2011年1月-2013年6月间入院收治的60例肺鳞癌患者，吉西他滨联合顺铂或卡铂方案予以化疗，采用 ELISA和免疫放射分析法测定患者化疗前、化疗1周期后血清 VEGF， SCC-Ag和CYFRA21-1的水平；并在化疗2周期后参照实体疗效评价标准（RECIST）进行疗效评价。结果有效组血清VEGF和CYFRA21-1水平分别为413±114 pg/ml和14.7±9.6 ng/ml，化疗1周期后血清VEGF和CYFRA21-1水平分别为272±131 pg/ml和10.8±7.1 ng/ml，化疗后明显下降（P值均＜0.01）。进展组血清VEGF和CYFRA21-1水平分别为472±207 pg/ml和18.9±17.6 ng/ml；化疗1周期后血清VEGF和CYFRA21-1水平分别为537±219 pg/ml和21.5±20.2 ng/ml，化疗后明显上升（P值均＜0.01）。稳定组血清 VEGF和CYFRA21-1水平分别为419±246 pg/ml和17.0±12.9 ng/ml；化疗1周期后血清 VEGF和CYFRA21-1水平分别为421±252 pg/ml和16.8±11.7ng/ml，治疗前后无明显变化（P值均＞0.05）。血清 SCC-Ag水平在各组治疗前后差异无统计学意义（P 值均＞0.05）。多重回归分析显示，血清VEGF，CYFRA21-1水平变化与肺鳞癌化疗疗效变化相关（t＝5.86，P＜0.001；t＝2.26，P＝0.027），而血清 SCC-Ag水平与肺鳞癌的化疗效果变化无明显相关（t＝1.52，P＝0.133）。结论血清 VEGF和CYFRA21-1表达水平变化与肺鳞癌化疗疗效相关，能够提前了解化疗效果，联合检测血清 VEGF和CYFRA21-1对评估中晚期肺鳞癌化疗疗效有一定的参考价值。

Objective To investigate the combined detection of serum vascular endothelial growth factor （VEGF）,squamous cell carcinoma antigen （SCC-Ag）and cytokeratin 19 fragment （CYFRA21-1）value in assessing the efficacy of chemotherapy in patients with advanced squamous cell carcinoma of the lung.Methods 60 cases of lung squamous cell carcinoma patients in January 2011 between June 2013 to be admitted to hospital were treated with gemcitabine plus cisplatin or carboplatin chemotherapy.Detected the levels of serum VEGF,SCC-Ag and CYFRA21-1 expression in 60 cases before and after 1 cycle of chemotherapy in patients using ELISA and immunoradiometric assay,and evaluated the efficacy evaluation with reference to RECIST criteria after 2 cycle of chemotherapy.Results Effective group serum VEGF and CYFRA21-1 levels were 413± 114 pg/ml and 14.7±9.6 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 272±131 pg/ml and 10.8±7.1 ng/ml,which decreased after chemotherapy （P〈0.01）.Progress group serum VEGF and CYFRA21-1 levels were 472±207 pg/ml and 18.9±17.6 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 537±219 pg/ml and 21.5±20.2 ng/ml,which increased after chemotherapy （P〈0.01）.Stable group serum VEGF CYFRA21-1 levels and were 419±246 pg/ml and 17.0±12.9 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 421±252 pg/ml and 16.8±11.7 ng/ml,which had no changes before and after treatment （P〉0.05）. Serum SCC-Ag levels before and after each treatment group difference was not statistically significant （P〉0.05）.Multiple regression analysis showed that serum VEGF,CYFRA2 1-1 levels and the efficacy of lung squamous were related changed （t=5.86,P〈0.001;t=2.26,P=0.027）,and there was no significant correlation between SCC-Ag levels changes and the effect of chemotherapy （t=1.52,P=0.133）.Conclusion Serum VEGF and CYFRA21-1 expression level changes associat-ed with squamous cell carcinoma of the lung chemotherapy effect,which can advance understanding of the effect of chemo-therapy,combined with advanced squamous cell carcinoma detection of serum VEGF and chemotherapy assessment CY-FRA2 1-1 has a certain reference value.