非手术食管癌患者放化疗中肿瘤组织病理反应和血清血管内皮生长因子的变化与其预后的关系

he Pathological Changes of Tumor Tissues and Serum Vascular Endothelial Growth Factor in Patients with Esophageal c Carcinoma Undergoing Rradiotherapy and Cchemotherapy

目的探讨非手术食管癌患者放化疗中肿瘤组织病理反应和血清血管内皮生长因子的变化及其对预后的影响。方法人选该院2010年12月一2013年12月收治的食管癌患者100例,根据放疗后肿瘤组织病理学特点分为轻度反应(n=20)、中度反应(n=28)及重度反应(n=41)3组;另选取同期健康人100名作为对照组;观察放疗前后研究对象血清VEGF水平变化及其对预后的影响,井采用Cox比例风险模型分析非手术食管癌患者生存期的影响因素。结果轻度反应组1年生存率、1年或3年无进展生存率以及1年或3年局部控制率均低于中、重度反应组(P<0.05)。非手术食管癌患者放疗前、放疗中和放疗后的血清VEGF水平均高于健康对照组(P<0.05 );放疗中和放疗后的血清VEGF水平呈逐渐下降趋势(P<0.05);血清VEGF水平升高组患者1,3年生存率低于降低组((P<0.05);血清VEGF水平升高组患者3年无进展生存率低于降低组(P<0.05)o TNM分期、肿瘤组织病理反应和VEGF水平变化是影响非手术食管癌患者生存期的独立因素。结论非手术食管癌患者放化疗过程中,肿瘤组织病理反应和血清VEGF变化可有效预测放化疗疗效,同时监测治疗中肿瘤组织病理反应和VEGF水平变化对指导临床个体化治疗起到重要的临床意义。

Objective To research the significance of pathological stage of radical prostate cancer and pathological sub-stage of pT2 and provide more objective basis for the clinical treatment of prostate cancer. Methods 50 cases of patients with radical prostate cancer diagnosed in our hospital from January 2013 to January 2015 were convenient selected and the pathological specimens were given the morphological observation and pathological stage according to the 2002/2010 TNM stage system, and the patients with pathological sub-stage of pT2 were traced and followed upby telephone, and then the results were statistically analyzed. Results In the postoperative pathological stage, there were 25 cases during the pT2 stage,15 cases during the pT3 a stage and 10 cases during the pT3 b stage, and of the patients during the pT2, there were 3 cases during the pT2 a stage（12%）, 0 case during the pT2 b period（0%）and 22 cases during the pT2c stage（88.0%）, and the follow-upresults showed that the patients during the pT2 a stage and pT2 c stage were survival, and there was no obvious difference in the survival rate between the two groups, and the difference was not statistically significant（P〉0.05）. Conclusion The pathological stage after the radical prostate cancer can directly and truly reflect the state of prostate cancer, which is of more value and significance to the evaluation and determination of prognosis, at the same time, the staging basis of pathological sub-stage of pT2 is not perfect, which needs the further optimization and improvement.