非小细胞肺癌患者化疗前后血清VEGF/血小板数和TGF-β1检测的临床意义

Clinical significance of serum VEGF/platelet count and TGF-beta 1 in patients with non-small cell lung cancer before and after chemotherapy

目的探讨非小细胞肺癌(NSCLC)患者化疗前后血清VEGF/血小板数和TGF-β1浓度的变化,探讨两者在病情监测中的临床价值。方法 72例NSCLC患者化疗前采用酶联免疫法测定血清VEGF/血小板数和TGF-β1浓度,化疗采用GP方案,连用2周期,治疗结束后1周再次测定血清VEGF/血小板数和TGF-β1浓度,并行胸部CT检查,根据CT结果分为化疗有效组(完全缓解+部分缓解)和无效组(病情稳定+疾病进展),组间比较采用t检验,以P<0.05为差异有统计学意义。结果 NSCLC患者化疗前血清VEGF/血小板数、TGF-β1浓度分别为(0.803±0.078)10^(-6)pg、45.56±4.54ng/ml,均高于对照组的(0.539±0.027)10^(-6)pg、16.02±2.32ng/ml,差异有统计学意义(t=19.57、39.56,P<0.05)。不同性别、年龄、病理类型和分化程度NSCLC患者之间血清VEGF/血小板数、TGF-β1浓度接近,差异均无统计学意义(P>0.05)。化疗有效组化疗前血清VEGF/血小板数为(0.810±0.121)10^(-6)pg,化疗后下降至(0.415±0.098)10^(-6)pg,差异有统计学意义(t=16.84,P<0.05);化疗无效组化疗前血清VEGF/血小板数为(0.815±0.104)10^(-6)pg,化疗后浓度明显升高,差异有统计学意义(t=24.42,P<0.05)。化疗有效组化疗前血清TGF-β1浓度为42.57±4.47ng/ml,化疗后浓度下降至20.75±3.43ng/ml,差异有统计学意义(t=26.72,P<0.05);化疗无效组化疗前血清TGF-β1浓度为41.90±5.26ng/ml,化疗后浓度为45.51±4.48ng/ml,差异有统计学意义(t=2.38,P=0.030)。结论血清VEGF/血小板数和TGF-β1浓度与肿瘤活动度密切相关,可用于判定NSCLC化疗近期疗效。

Objective To investigate the changes of serum VEGF/platelet count and TGF-beta 1in patients with NSCLC before and after chemotherapy and to explore their clinical value as biomarkers.Methods A total of 122 subjects were recruited at the First Hospital of Qinhuangdao between February 2013 and January 2015,including 72 NSCLC patients receiving chemotherapy（NSCLC group）and 50 healthy controls（control group）.All NSCLC patients received gemcitabine plus cisplatin（GP regimen）for a total of two courses.Serum VEGF/platelet count and TGF-beta1 were measured before and after chemotherapy using enzyme-linked immunosorbent assay（ELISA）.NSCLC group was categorized into complete response（CR）plus partial response（PR）group and stable disease（SD）plus progressive disease（PD）group based on the results of CT scans obtained 1week after chemotherapy.Results Serum VEGF/platelet count and TGF-beta 1were significantly higher in NSCLC group before chemotherapy compared to the control group（VEGF/platelet count,0.803±0.078 vs 0.539±0.027;t=19.57;P〈0.05 and TGF-β1,45.56±4.54 vs 16.02±2.32;t=39.56;P〈0.05）.There were no significant differences in serum VEGF/platelet count and TGF-beta 1in patients with different gender,age,pathological type and differentiation degree（P〉0.05）.Importantly,serum VEGF/platelet count and TGF-beta 1decreased significantly after chemotherapy in CR＋PR group in comparison with before chemotherapy（VEGF/platelet count,0.415±0.098 vs 0.810±0.121;t=16.84;P〈0.05 and TGF-β1,20.75±3.43 vs 42.57±4.47;t=26.72;P〈0.05）.By contrast,serum VEGF/platelet count and TGF-beta 1were markedly higher after chemotherapy in the SD＋PD group in comparison with before chemotherapy（VEGF/platelet count,0.815±0.104 vs 1.178±0.106;t=24.42;P〈0.05 and TGF-β1,41.90±5.26 vs 45.51±4.48;t=2.38;P=0.030）.Conclusion Serum VEGF/platelet count and TGF-beta 1are closely related to tumor activity,which can be used to determine the short-term efficacy of NSCLC chemotherapy.