恶性脑胶质瘤同步放化疗后血清TGF-β和GFAP浓度变化及其临床意义

Concentration Change of Serum TGF-β and GFAP and Their Clinical Significance in Patients with Malignant Brain Glioma Treated by Concomitant Radiochemotherapy

目的探讨脑胶质瘤患者治疗后血清TGF-β和GFAP浓度的变化对其预后的影响。方法选择Ⅲ~Ⅳ级脑胶质瘤患者56例,采用术后三维适形放疗联合口服替莫唑胺化疗。分别于术前、术后1周和放化疗结束后抽取患者静脉血3 ml检测血清TGF-β和GFAP浓度。结果Ⅲ级脑胶质瘤患者血清TGF-β浓度显著低于Ⅳ级脑胶质瘤患者,差异有统计学意义(P<0.05);Ⅲ级脑胶质瘤患者血清GFAP浓度显著高于Ⅳ级脑胶质瘤患者,差异有统计学意义(P<0.05)。与术前比较,术后1周和放化疗结束后患者血清TGF-β和GFAP浓度显著降低,差异有统计学意义(P<0.05);与术后1周比较,放化疗结束后患者血清TGF-β和GFAP浓度显著降低,差异有统计学意义(P<0.05)。不同疗效组患者血清TGF-β和GFAP浓度差异显著(P<0.05);与CR组比较,SD、PD组患者血清TGF-β浓度显著升高,PR、SD、PD组患者血清GFAP浓度显著升高,差异有统计学意义(P<0.05);与PR组比较,SD、PD组患者血清TGF-β和GFAP浓度均显著升高,差异有统计学意义(P<0.05);与SD组比较,PD组患者血清TGF-β和GFAP浓度均显著升高,差异有统计学意义(P<0.05)。结论 TGF-β和GFAP是评估脑恶性胶质瘤疗效及预后的良好血清标志物,具有重要的临床价值。

Objective To investigate the serum TGF-β and GFAP concentration changes in patients with malignant brain glioma and its influence on prognosis. Methods A total of 56 cases of stage m - IV brain glioma patients were selected. All the patients used postoperative three dimensional conformal radiotherapy combined with oral administration of chemotherapy for treatment. The serum TGF-β and GFAP at the preoperative, postoperative 1 week and after the end of radiochemotherapy were detected. Results The serum TGF-β concentration of grade m brain glioma patients was significantly lower than that of the grade Ⅳ glioma patients and the difference was statistically significant （ P 〈 0.05 ）. The level of serum GFAP in patients with grade Ⅲ glioma was significantly higher than that in patients with grade Ⅳ gliomas, and the difference was statistically significant （ P 〈 0.05 ）. Compared with the preoperative,the serum TGF-β and GFAP concentration decreased significantly at 1 week postoperative chemotherapy and after radiochemotherapy, the differences were statistically significant （ P 〈 0.05 ）. Compared with 1 weeks after surgery, serum TGF-β and GFAP concentrations were significantly decreased in patients after radiochemotherapy, and the difference was statistically significant （P 〈0.05 ）. The difference of serum levels of TGF-β and GFAP concentration was statistically significant （P 〈 0.05 ）. Compared with the CR group, serum TGF-β concentration in patients of SD and PD group increased significantly, and serum GFAP concentration in patients of PR, SD, PD groups increased significantly, the differences were statistically significant （P 〈 0.05 ）. Compared with the PR group ,the serum levels of TGF-β and GFAP were significantly increased in patients of SD and PD group, and the difference was statistically significant （ P 〈 0. 05 ）. Compared with the SD group, the serum levels of TGF-β and GFAP were significantly increased in patients of PD group, and the difference was statistically significant （P 〈 0.05 ）. Conclusion TGF-β and GFAP are good serum markers for the evaluation of the curative effect and prognosis of brain malignant glioma, which has important clinical value.