血管内皮生长因子和黏附分子蛋白CD44变异体6与非小细胞肺癌同步放化疗近期疗效的相关性

Relation among vascular endothelial growth factor, adhesion molecule protein CD44v6 and short-term outcome of chemoradiotherapy in patients with non-small-cell lung cancer

目的分析血管内皮生长因子（VEGF）和黏附分子蛋白CD44变异体6（CD44v6）与非小细胞肺癌（NSCLC）同步放化疗近期疗效的相关性。方法回顾性分析2013年1月至2015年1月经解放军第一○五医院肿瘤三科病理确诊的72例NSCLC初诊患者的临床资料。所有患者行同步放化疗，治疗1个月。采用酶联免疫吸附试验法检测同步放化疗前1周内和同步放化疗1个月后患者血清VEGF和CD44v6水平。分析血清VEGF和CD44v6水平变化与NSCLC同步放化疗近期疗效的相关性。结果同步放化疗前后，有吸烟史患者血清VEGF和CD44v6水平高于无吸烟史患者；鳞癌患者血清VEGF和CD44v6水平高于腺癌患者；临床分期Ⅲa＋Ⅲb期患者血清VEGF和CD44v6水平明显高于Ⅱ期患者（P＜0.05或P＜0.01）。在所有患者中，完全缓解12例，部分缓解42例，稳定14例，进展4例，客观有效率为75.0%（54/72），疾病控制率为94.4%（68/72）。血清VEGF和CD44v6水平同步放化疗前分别为（595±102） ng/L和（461±21） μg/L，同步放化疗后分别为（565±84） ng/L和（431±16） μg/L；上述二者同步放化疗后均低于同步放化疗前（均P＜0.05）。在完全缓解、部分缓解、客观有效和疾病控制患者中，血清VEGF和CD44v6水平同步放化疗后低于同步放化疗前（P＜0.05或P＜0.01）；在稳定患者中，血清VEGF水平同步放化疗后低于同步放化疗前（P＜0.05）。结论血清VEGF和CD44v6水平与NSCLC多种临床病理特征相关，可作为NSCLC同步放化疗近期疗效判断及预后的可靠指标。

ObjectiveTo analyze the relation among vascular endothelial growth factor（VEGF）, adhesion molecule protein CD44v6 and short-term outcome of chemoradiotherapy in patients with non-small-cell lung cancer（NSCLC）. MethodsClinical data of 72 patients diagnosed of NSCLC from January 2013 to January 2015 in the 105th Hospital of Chinese People′s Liberation Army were retrospectively analyzed. All patients were treated with concurrent chemoradiotherapy for 1 month. Serum levels of VEGF and CD44v6 were measured by enzyme linked immunosorbent assay 1 week before and 1 month after therapy. Relations of VEGF and CD44v6 with the 1-month efficacy of chemoradiotherapy were analyzed. ResultsBefore and after therapy, serum levels of VEGF and CD44v6 in patients with smoking history were significantly higher than those in patients without smoking history; serum levels of VEGF and CD44v6 in squamous carcinoma patients were significantly higher than those in adenocarcinoma patients; serum levels of VEGF and CD44v6 in patients with stage Ⅲa＋Ⅲb cancer were significantly higher than those in patients with stage Ⅱ cancer（P〈0.05 or P〈0.01）. Among 72 patients, there were 12 cases of complete remission, 42 cases of partial remission, 14 cases of stable disease and 4 cases of progressive disease; the objective response rate was 75.0%（54/72）; the disease control rate was 94.4%（68/72）. Serum levels of VEGF and CD44v6 after therapy were significantly lower than those before therapy[（565±84）ng/L vs （595±102）ng/L, （431±16）μg/L vs （461 ±21）μg/L]（P〈0.05）. In patients with complete remission, partial remission, objective response and disease control, serum levels of VEGF and CD44v6 significantly decreased after therapy（P〈0.05 or P〈0.01）. In patients with stable disease, serum level of VEGF significantly decreased after therapy（P〈0.05）. ConclusionChanges of serum VEGF and CD44v6 may reflect clinical and pathological features of NSCLC; they can be used as predictive indicators for short-term efficacy and prognosis of chemoradiotherapy for NSCLC.