晚期非小细胞肺癌循环血管内皮细胞水平的研究

目的分析晚期非小细胞肺癌(NSCLC)患者治疗前后外周血中循环血管内皮细胞(CEC)的变化,探讨CEC在NSCLC中的应用价值。方法采用NP方案联合内皮抑素(治疗组)及单用NP方案(对照组)治疗晚期NSCLC 67例,流式细胞法检测治疗前后外周血CEC数量及细胞角蛋白(CK)水平。结果治疗组临床有效率为44．4％,对照组为27．3％(P=0．176);治疗组临床受益率为80．0％,对照组为50．0％(P=0．012)。治疗组肿瘤进展时间(TTP)为146．7 d,对照组为91．1 d (P=0．061)。当TTP的cut-off值>170时,两组TTP比较,差异有统计学意义(cut-off值=170,P= 0．034;cut-off值=180,P=0．009)。治疗组CEC平均下降(0．29±0．47)％,对照组平均下降(0．01±0．43)％(P=0．033)。全部患者治疗前CEC与CK水平呈正相关(r=0．381,P=0．013),治疗后亦呈正相关(r=0．450,P=0．004)。结论化疗联合血管靶向治疗晚期NSCLC优于单用化疗,CEC是一个较好的预测疗效的指标。

Circulating endothelial cells in the peripheral blood of advanced NSCLC patients

OBJECTIVE: To investigate the changes and clinical value of circulating endothelial cells (CEC) in the peripheral blood of advanced NSCLC patient. METHODS: Sixty-seven advanced NSCLC patients were randomly divided into either the treatment group with NP plus endostatin or control group with NP alone. Level of CEC and cytokeratin (CK) in the peripheral blood were measured by flow cytometry. RESULTS: The response rate and benefit rate was 44.4%, 80.0% in the treatment group, and 27.3%, 50.0% in the control group, respectively (P = 0.176 and P = 0.012). Time to tumor progression (TTP) was 146.7 days in the treatment group and 91.1 days in the control group (P = 0.061). However, when the cut-off of TTP was defined as > 170 days, there was a significant difference between two groups (cut-off = 170, P = 0.034; cut-off = 180, P = 0.009). The number of CEC decreased by 0.29 +/- 0.47 in the treatment group and by 0.01 +/- 0.43 in the control group (P = 0.033). The correlation between CEC and CK was found to be positive either before (r = 0.381, P = 0.013) or after the treatment (r = 0.450, P = 0.004). CONCLUSION: Chemotherapy combined with endostatin is superior to chemotherapy alone in the treatment of NSCLC. CEC, as a biomarker, may be useful in predicting the efficacy of the combined treatment.