血清bFGF、HIF-1α、IL-6对晚期肺腺癌贝伐珠单抗联合化疗疗效及预后的预测价值

Predictive value of serum bFGF,HIF-1α,IL-6 on the efficacy and prognosis of bevacizumab combined chemotherapy in advanced lung adenocarcinoma

目的胞介素6(IL-6)对贝伐珠单抗联合化疗治疗晚期肺腺癌(LUAD)疗效及预后的预测价值。方法选取2017年1月至2019年6月南京市胸科医院及南京医科大学附属江宁医院收治的晚期LUAD患者80例,予以贝伐珠单抗联合化疗治疗,应用ELISA方法测定治疗前血清bFGF、HIF-1α、IL-6水平,根据治疗效果将患者分为非缓解患者(A组)、缓解患者(B组),分析血清bFGF、HIF-1α、IL-6水平与患者临床疗效及预后的关系。结果 A组血清bFGF、HIF-1α、IL-6水平明显高于B组,差异有统计学意义(P<0.05)。Logistic回归分析提示血清bFGF、HIF-1α、IL-6水平是影响治疗效果的独立因素(P<0.05)。根据ROC曲线分析,血清bFGF、HIF-1α、IL-6预测疗效的曲线下面积(AUC)分别为0.822、0.844、0.833,三者联合预测的AUC为0.894(P<0.05)。血清b FGF、HIF-1α、IL-6高表达组与低表达组中位PFS比较,差异有统计学意义(P<0.05)。COX风险回归分析显示,血清bFGF、HIF-1α、IL-6是影响晚期LUAD预后的独立因素(P<0.05)。结论血清bFGF、HIF-1α、IL-6水平低提示贝伐珠单抗联合化疗治疗晚期LUAD疗效及预后良好,有助于预测患者疗效及预后,且三者联合预测疗效效果更佳。

Objective To investigate the prognostic value of serum basic fibroblast growth factor(b FGF),hypoxia inducible factor-1α(HIF-1α)and interleukin-6(IL-6)on bevacizumab combined with chemotherapy in the treatment of advanced lung adenocarcinoma(LUAD). Methods A total of 80 patients with advanced LUAD who were admitted to Nanjing Chest Hospital and Jiangning Hospital affiliated to Nanjing Medical University from January 2017 to June 2019 were selected and treated with bevacizumab combined with chemotherapy. Serum bFGF,HIF-1α and IL-6 levels before treatment were determined by ELISA. Patients were divided into non-remission group(group A)and remission group(group B)according to the treatment effect,and the relationship between serum b FGF,HIF-1α,IL-6 levels and clinical efficacy and prognosis were analyzed. Results The levels of serum bFGF,HIF-1α and IL-6 in group A were significantly higher than those in group B,the differences were statistically significant(P<0.05). Logistic regression analysis showed that serum bFGF,HIF-1α and IL-6 levels were independent factors affecting the therapeutic effect(P<0.05).According to ROC curve analysis,the AUC of serum b FGF,HIF-1α and IL-6 was 0.822,0.844 and 0.833,respectively,and the AUC of serum b FGF,HIF-1α and IL-6 was 0.894. The median PFS of b FGF,HIF-1αand IL-6 in high expression group and low expression group were significantly different(P<0.05). COX risk regression analysis showed that serum b FGF,HIF-1α and IL-6 were independent factors affecting the prognosis of late LUAD(P<0.05). Conclusion The low levels of serum b FGF,HIF-1α and IL-6 suggest that bevacizumab combined with chemotherapy in the treatment of advanced LUAD has a good curative effect and prognosis,which is helpful to predict the curative effect and prognosis of patients,and the combination of the three is better in predicting the curative effect.