乳腺癌患者VEGF的表达水平与联合化疗疗效的相关性研究

Correlation of Expression of VEGF Levels and Combination Chemotherapy Effect in Patients with Breast Cancer

目的探讨分析采用三维超声评估乳腺癌患者多柔比星与多西他赛化疗后临床和病理特征变化的效果。方法选取80例乳腺癌患者进行前瞻性研究,对纳入患者随机分组,根据乳腺癌最新化疗方案指南,化疗药物分为三类化疗方案,A类为蒽环类药物,联合5-FU和CTX;B类为蒽环类联合紫彬类;C为非蒽环类联合紫彬类药物。所有患者均给予4或6个周期的化疗,持续静脉注射,21 d为一周期,化疗后行手术切除,采用免疫组化SABC法检测组织血管内皮生长因子(VEGF)的表达水平,并根据表达阳性程度分为弱表达组和强表达组,同时采用Elisa检测化疗前、后的血清VEGF水平,比较VEGF水平与化疗前、后患者临床和病理缓解的关系。结果 VEGF阳性表达51例,组织表达率为63.75%,VEGF弱表达组的临床缓解率高达79.31%,与强阴性组比较差异有统计学意义;在56例临床缓解患者中,化疗后血清VEGF水平明显下降显著低于化疗前,与临床未改善组比较差异有统计学意义。在52例接受蒽环类化疗药物化疗患者中,血清VEGF水平亦明显低于非蒽环类化疗方案者,差异有统计学意义。结论 VEGF表达水平与乳腺癌病情发展关系密切,是衡量化疗效疗重要指标,特别是对蒽环类药物具有更为明显的参考价值。

Objective To study the correlation of expression of VEGF levels and combination of doxorubicin and doctaxel chemotherapy effect in patients with breast cancer. Methods 80 patients with breast cancer were selected. And according to the latest chemotherapy guidelines for breast cancer,there were three types of chemotherapy drugs. Class A was anthracycline-based drugs,joint 5-FU and CTX; class B was anthracycline-based joint purple bin,and class C is joint purple ball combined with anthracycline-based drugs. All patients were given four or six cycles of chemotherapy and continuous intravenous injection. 21 days was a cycle.Immunohistochemical SABC method was used to detect VEGF expression level,and according to the degree of expression,patients were divided into weak expression group and strong expression group. At the same time,the serum level of VEGF were detected by Elisa test before and after chemotherapy. Results There are 51 cases with VEGF positive expression. Tissue expression rate is63. 75%. Clinical remission rate in weak group is as high as 79. 31%. There is statistically significant difference compared with strong group. In 56 clinical alleviate patients,serum VEGF levels are significantly decreased after chemotherapy with statistical significance difference compared with clinical imperfect group. In 52 cases receiving anthracycline-based chemotherapy drugs,the serum VEGF levels are significantly lower than the anthracycline-based chemotherapy regimens,with statistical significance. Conclusion VEGF expression level is closely associated with breast cancer development. It is an important index for chemotherapy efficiency,and especially for anthracycline-based drugs. VEGF has more obvious reference value.