开胸手术对非小细胞肺癌患者血清VEGF、MMP-9水平变化的影响分析

目的 分析开胸手术对非小细胞肺癌(non-small cell lung cancer)患者血清VEGF、MMP-9水平变化的影响.方法 将非小细胞肺癌患者79例作为观察组;良性肺部疾病患者56例和健康志愿者25例作为对照组.观察组患者和良性肺部疾病患者均进行了开胸肺切除手术,然后按照病理类型和TNM分期对观察组患者治疗前的VEGF、MMP-9水平进行检测统计,并与健康对照组比较分析,并对治疗前后观察组和良性对照组患者的VEGF、MMP-9水平进行统计分析.结果 按照患者病理类型检测VEGF水平为:腺癌(332.3±82.3)pg/ml,鳞癌(364.5±81.8)pg/ml,其他病理类型(375.8±88.6)pg/ml;所有患者的MMP-9水平分别为腺癌(199.4±82.2)ng/ml,鳞癌(183.2±102.6)ng/ml,其他病理类型(185.1±112.9)ng/ml,所有肺癌患者的VEGF水平和MMP-9水平均显著高于健康对照组(P<0.05).Ⅰ期患者的VEGF水平和MMP-9水平分别为(245.4±54.3)pg/ml和(141.2±58.2)ng/ml,明显低于其他分期患者VEGF水平和MMP-9水平(P<0.05).观察组患者治疗前后VEGF水平和MMP-9水平均显著高于良性对照组患者(P<0.05).结论开胸手术治疗非小细胞肺癌患者,术后患者的VEGF水平和MMP-9水平明显升高,但没有明显的相关性.患者术前VEGF水平和MMP-9水平也明显高于良性肺部疾病患者,且与患者的分化程度相关.     

非小细胞肺癌患者术后血清VEGF动态变化与血小板的相关性研究

背景与目的已有研究表明:非小细胞肺癌(non-small cell lung cancer,NSCLC)患者手术切除原发肿瘤后其血清中血管内皮生长因子(vascular endothelial growth factor,VEGF)浓度显著升高,血小板可能是血清中VEGF的主要来源。本研究的目的是探讨NSCLC患者术后血清VEGF浓度的动态变化及其与血小板之间的关系。方法应用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测法,监测76例非小细胞肺癌患者术前、术后1天及7天血清VEGF的浓度,同期检测血小板的浓度。结果①NSCLC患者术前、术后1天及7天血清VEGF分别为(842.06±527.24)pg/mL、(1119.28±609.62)pg/mL、(1574.09±873.38)pg/mL,组间比较差异具有统计学意义(P<0.001);②NSCLC患者术前、术后1天及7天血小板计数分别为(230.42±82.56)×109/L、(196.47±81.48)×109/L、(237.90±86.94)×109/L,术后1天最低(P<0.001);③术后7...     

非小细胞肺癌患者血清VEGF表达水平及其临床意义

目的：检测非小细胞肺癌（NSCLC）患者血清血管内皮生长因子（vascula rendothelial growth factor,VEGF）的表达水平,探讨其临床意义。方法：应用酶联免疫吸附法（ELISA）检测114例NSCLC和87例健康对照组血清中VEGF水平,计算VEGF的灵敏度和特异度,阳性预测值和阴性预测值,分析患者治疗前血清VEGF水平对其近期疗效的影响以及VEGF与CYFRA21-1和CEA联合检测的临床意义。结果：（1）NSCLC组血清VEGF平均水平为203.70ng/L,对照组为76.21ng/L,两组差别有统计学意义（P〈0.001）。有负荷组患者血清VEGF水平高于无负荷组（P〈0.001）。（2）VEGF以200.6ng/L为医学参考值上限,VEGF对NSCLC诊断的灵敏度为69.7%,特异度为96.4%;有负荷组患者灵敏度可达到81.9%,而无负荷组仅为33.7%,其差别有统计学意义（P〈0.01）。（3）NSCLC患者随着血清VEGF平均水平的升高,其疗效逐渐降低（P〈0.05）。3种肿瘤标记物联合分析显示,随着患者血清肿瘤标记物阳性数目的增多,无效患者的比例呈上升趋势,当患者血清肿瘤标记物阳性数目达到3种时,约87.5%的患者治疗无效。（4）血清VEGF水平与肿瘤大小、分化程度及临床分期密切相关（P〈0.01）,与患者的年龄无关（P〉0.05）。结论：VEGF在NSCLC的发生、生长和转移过程中起着极其重要的作用,有可能成为一种新的肿瘤标记物用于NSCLC的辅助诊断或检测指标。     

Serum endostatin levels are elevated and correlate with serum vascular endothelial growth factor levels in patients with stage IV clear cell renal cancer.

Clear cell renal carcinoma (CCRC) is a highly angiogenic tumor known to secrete vascular endothelial cell growth factor (VEGF). Endostatin is an endogenous antiangiogenic agent with antitumor activity in mice. The purpose of this study was to evaluate serum levels of endostatin in normal subjects and in patients with CCRC and to examine the relationship of these levels to circulating VEGF levels. Fifteen patients (mean age, 48 years) on a clinical protocol for stage IV CCRC at the National Cancer Institute were included in the study. Archived prenephrectomy serum samples were analyzed for endostatin and VEGF concentrations. Endostatin and VEGF levels were compared with those of an age-matched group of volunteer blood donors (n = 18) using a competitive enzyme immunoassay. Data were analyzed using the Mann-Whitney U test and the Spearman rank correlation. Median serum endostatin levels were 24.6 ng/ml (range, 15.1-54.0 ng/ml) in CCRC patients versus 14.1 ng/ml (range, 1.0-19.3 ng/ml) in healthy controls (P < 0.0001). Median VEGF levels were 3.4 ng/ml (range, 0.1-11.2 ng/ml) and 2.5 ng/ml (range, 0.1-4.2 ng/ml), respectively (P = 0.065). A highly significant correlation was observed between endostatin and VEGF levels among the CCRC patients (r = 0.81, P = 0.0003) but not among controls (r = -0.22, P = 0.37). Endostatin levels are detectable in serum from healthy subjects as well as from CCRC patients. Levels are significantly elevated and correlate with VEGF levels in CCRC patients. Elucidating the nature of this correlation may lend insight into the regulation of tumor angiogenesis in patients with renal cancer.     

Serum VEGF and bFGF adds prognostic information in patients with normal platelet counts when sampled before, during and after treatment for locally advanced non-small cell lung cancer

Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) have both been implicated to have roles in tumour angiogenesis. In the present retrospective study, serum VEGF and bFGF from patients with locally advanced non-small cell lung cancer (NSCLC) were analysed before, during and after treatment. Seventy-three patients and a total of 460 serum samples were analysed for VEGF and 443 serum samples were analysed for bFGF. Pre-treatment bFGF levels in patients with normal platelet counts, were correlated to poorer survival, P-value = 0.047. During chemotherapy, each rise of one unit bFGF corresponded to a hazard ratio of 4.06 (P=0.022). In patients with normal platelet counts, VEGF levels after radiotherapy significantly correlated to good prognosis (P=0.023), during radiotherapy VEGF levels indicated the same correlation (P=0.085). We conclude that serum VEGF and especially bFGF are of clinical interest as prognostic factors, especially in patients presenting with normal platelet counts.     

Pretreatment serum endostatin as a prognostic indicator in metastatic gastric carcinoma

Endostatin is the C-terminal antiangiogenic fragment of the extracellular matrix protein collagen XVIII, and is generated by tumor-derived proteases. The presence of serum endostatin in patients with gastric cancer has not been reported. The authors assessed the serum levels of endostatin in patients with gastric carcinoma and evaluated their association with the levels of vascular endothelial growth factor (VEGF) and the clinical outcome. A total of 107 patients with gastric cancer were included in the study. Pretherapeutic serum levels of endostatin and VEGF were measured using an ELISA, and compared with those in 23 healthy controls. The serum levels of endostatin and VEGF were higher in gastric cancer patients than in healthy controls (endostatin, 70.1 +/- 16.6 vs. 52.2 +/- 6.2 ng/mL [p < 0.001]; VEGF, 55.1 +/- 7.6 vs. 32.1 +/- 2.4 ng/mL [p < 0.001]; mean +/- SD). Serum endostatin levels were significantly associated with the presence of distant metastases (r = 0.556, p < 0.001) and VEGF levels (r = 0.335, p < 0.001), but not with the depth of tumor invasion, differentiation, or regional lymph node status. A serum endostatin level above the 75th percentile of the distribution for the patients (79.2 ng/mL) was associated with a poor outcome (last follow-up at 42 months; median survival time, 9 vs. 20 months [log-rank, p = 0.017]; median time to progression, 5 vs. 10 months [log-rank, p = 0.022]) in the patients with metastatic gastric cancer. The results suggest for the first time that an elevated serum level of endostatin at the diagnosis of metastatic gastric cancer could be predictive of a poor outcome.     

Elevated preoperative serum levels of angiogenic cytokines correlate to larger primary tumours and poorer survival in non-small cell lung cancer patients

We have analysed the predictive and prognostic information in preoperatively collected serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in patients clinically evaluated as operable non-small cell lung cancer (NSCLC). Fifty-eight patients with operable NSCLC were included. VEGF and bFGF levels in serum were analysed using enzyme linked immunosorbent assays (Quantikine human VEGF and Quantikine HS human FGF basic, R&D Systems). Univariate analysis demonstrated that tumour volume, platelet counts, VEGF and bFGF were significant prognostic factors. However, only bFGF remained significant in the multivariate analysis (P=0.014). Significant correlation's were demonstrated between VEGF levels and tumour volume (r=0.33; P=0.012) and platelet count (r=0.43; P=0.001). bFGF levels correlated significant with recurrent disease (r=0.34; P=0.01), platelet count (r=0.53, P<0.001) and performance status (r=0.29; P=0.029). Furthermore, bFGF levels and VEGF levels correlated significantly (r=0.44; P<0.001). We conclude that elevated circulating angiogenic cytokines correlate with tumour volume, higher relapse risk and poorer survival in patients with operable non-small cell lung cancer.     

Pro-gastrin-releasing peptide in patients with benign and malignant diseases.

The specificity and sensitivity of pro-gastrin-releasing peptide (ProGRP) was evaluated in 37 healthy subjects, 197 patients with benign diseases and 310 patients with malignant diseases of different origins. Abnormal ProGRP serum levels (>50 pg/ml) were found in 10% of the patients with benign diseases and in 26.1% of the patients with active cancer. None of the healthy subjects had abnormal ProGRP levels. The benign disease with the highest ProGRP concentration was renal failure, with abnormal values in 51.6% of the patients studied. Excluding patients with renal failure or patients with creatinine levels greater than 1.5 mg/dl, raised ProGRP values (<80 ng/ml) were found in 2.5% (4/160) of patients with benign diseases and in 4.9% of patients with active malignancies other than lung cancer or neuroendocrine tumors (<110 ng/ml). Abnormal ProGRP serum levels were found in 26.2% of patients with non-small cell lung cancer (NSCLC) (mean 40.5 +/- 35.4 pg/ml) and in 76.8% of patients with small cell lung cancer (SCLC) (mean 694 +/- 1,776 pg/ml) (p < 0.001). ProGRP serum levels >300 pg/ml were only found in SCLC patients (41.4%). ProGRP results were related to tumor extension in SCLC (sensitivity in limited disease 58.3%, in extensive disease 95.5%) but not in NSCLC. In summary, renal failure is the most frequent source of false-positive results with ProGRP, and this marker is useful in the histological differential diagnosis of lung cancer.     

Tamoxifen and aromatase inhibitors differentially affect vascular endothelial growth factor and endostatin levels in women with breast cancer.

PURPOSE: Circulating and cellular proangiogenic and antiangiogenic proteins such as vascular endothelial growth factor (VEGF) and endostatin contribute to the local angiogenic balance. We explored the effects of tamoxifen and aromatase inhibitors on concentrations of VEGF and endostatin in plasma, serum, and platelet releasate (induced by platelet activation). EXPERIMENTAL DESIGN: VEGF and endostatin concentrations were measured with a quantitative immunoassay before and after 1 to 5 weeks of treatment in 30 women with breast cancer treated with either tamoxifen (n = 14) or aromatase inhibitors (n = 16). Platelet activation was induced by a thrombin receptor agonist. RESULTS: Tamoxifen therapy resulted in an increase in platelet releasate concentrations of VEGF (P = 0.01) but no change in plasma VEGF. In contrast, aromatase inhibitor therapy did not affect serum, plasma, or platelet releasate VEGF. In univariate analysis, aspirin use attenuated the tamoxifen-associated increase in VEGF in the platelet releasate and decreased serum levels of VEGF (P = 0.03). Aromatase inhibitor therapy resulted in a decrease in serum endostatin concentrations (P = 0.04), whereas plasma concentrations of endostatin tended to be higher during treatment with aromatase inhibitors (P = 0.06). Tamoxifen therapy resulted in no change in serum or plasma endostatin concentrations. Platelet releasate concentrations of endostatin did not change with either treatment. Interindividual variability was noted among both aromatase inhibitor--and tamoxifen-treated patients. CONCLUSIONS: Tamoxifen and aromatase inhibitor therapy affect VEGF and endostatin levels and likely contribute to the angiogenic balance in breast cancer patients. Aspirin decreased the proangiogenic effects of tamoxifen, suggesting that antiplatelet and/or antiangiogenic therapy might improve the effectiveness of tamoxifen in women with breast cancer.     

Clinical usefulness of serum and plasma vascular endothelial growth factor in cancer patients: which is the optimal specimen?

Vascular endothelial growth factor (VEGF) is secreted by various human cancer cells and plays a key role in cancer angiogenesis and metastasis. Recently, evidence of VEGF storage in blood cells including platelets has been reported. The serum VEGF levels were reported to increase during clotting as a result of its release from platelets, and plasma sample instead of serum was recommended for measuring the circulating VEGF more accurately. However, platelets have been implicated in tumor metastasis since circulating tumor cells forming aggregates with platelets were observed. The purpose of this study was to clarify which is an optimal specimen to measure VEGF in cancer patients, serum or plasma. We measured serum and plasma VEGF levels and platelet counts in 173 cancer patients and 42 healthy people, and found that serum VEGF levels were significantly higher than matched plasma VEGF and the VEGF difference (serum VEGF - plasma VEGF) correlated with platelet counts (r=0.624, p<0.05) in both cancer patients and healthy controls. We selected cancer patients with normal platelet counts (130-400x103/microl, Plt-normal cancer group). Interestingly, serum VEGF levels were higher in Plt-normal cancer group than in healthy controls. The theoretical platelet-derived VEGF in serum, calculated based on actual blood platelet counts (pg per 106 platelets), was also significantly higher in Plt-normal cancer group than in normal controls. It is, therefore, suggested that, although the serum VEGF levels are affected by blood platelets, platelet-derived VEGF also reflect biology of cancer cells, and that serum would be the more useful specimen for measurement of circulating VEGF in cancer patients for prognosis.     

Serum PDGF-AB in pleural mesothelioma.

Overexpression of platelet-derived growth factor (PDGF) has been observed in lung and pleural tumors. The aim of this study was to evaluate the diagnostic and prognostic role of serum PDGF in pleural mesothelioma (PM). Four groups of subjects were studied: 93 malignant PM patients, 33 primary non small cell lung cancer patients, 51 subjects exposed to asbestos, defined as high-risk controls, and 24 healthy controls. PDGF-AB mean concentration was higher in PM patients (45.8 ng/ml) than in high-risk controls (33.1 ng/ml) and healthy controls (26.8 ng/ml). Using the cut-off level of 49.8 ng/ml, corresponding to the mean+2SD of PDGF-AB in healthy controls, 43% of PM patients showed positive PDGF-AB levels. Survival was evaluated in 82 PM patients. At the end of the follow-up (median 9.8 months) 80.5% of patients had died. Median survival was 13.1 and 7.9 months for patients with PDGF-AB lower and higher than the cut-off, respectively. Adjusting for age, sex, histology and platelet count, positive PDGF-AB levels were associated with lower survival (OR=1.2, 95%CI: 0.9-1.6), even if not significantly so. In conclusion, serum PDGF may represent a useful additional parameter to prognostic factors already available for PM.     

晚期恶性肿瘤血清VEGF含量测定的临床意义

目的：探讨血清血管内皮生长因子（VEGF）浓度在晚期恶性肿瘤中的临床意义。方法：应用酶联免疫吸附试验（ELISA）测定40例晚期恶性肿瘤（非小细胞肺癌、鼻咽癌、食管癌）患者血清的VEGF浓度，10名健康成人作为对照。结果：40例晚期恶性肿瘤患者血清VEGF浓度为（477．07±374．10）pg／ml，显著高于健康成人（139．09±133．41）pg／ml，差异有统计学意义（P=0．016），其中治疗前血清VEGF浓度在非小细胞肺癌为（518．53±378．99）pg／ml，食管癌为（399．21±393．69）pg／ml，鼻咽癌为（500．68±348．48）pg／ml，与健康成人比较差异有统计学意义（P值分别为0．011、0．044和0．019）。化疗有效患者的血清VEGF浓度（400．41±332．84）pg／ml显著低于化疗前浓度（777．10±666．01）pg／ml，差异有统计学意义（P=0．034）。结论：血清VEGF可作为晚期恶性肿瘤监测病情、判断放疗和预后一个有用的指标。     

Overexpression of collagen XVIII is associated with poor outcome and elevated levels of circulating serum endostatin in non-small cell lung cancer.

PURPOSE: The aim of this study was to determine whether collagen XVIII expression is correlated with circulating serum endostatin and whether this has any prognostic value in patients with non-small cell lung cancer (NSCLC). EXPERIMENTAL DESIGN: Serum endostatin levels were measured quantitatively by a competitive enzyme immunoassay, and collagen XVIII expression in tumor tissue was investigated with an immunohistochemical method in a series of 94 patients who underwent surgery for NSCLC. RESULTS: Sixty cases (63.8%) had positive immunohistochemical staining with anticollagen XVIII polyclonal antibodies, including strongly positive staining in 11 (11.7%) cases. The mean (+/- SD) serum endostatin level was 41.6 +/- 34.4 ng/ml in the patient group and 16.3 +/- 10.3 ng/ml in the control group (P < 0.0001). The 11 cases who were strongly collagen XVIII-positive had significantly higher serum endostatin levels than the cases who were negative or weakly positive (P = 0.0297). The 5-year survival rates of negative, weakly positive, and strongly positive patients were 77.8%, 56.9%, and 43.8%, respectively. The cases with strongly positive collagen XVIII expression had a significantly poorer outcome than cases with negative expression (P = 0.0027). A multivariate analysis with Cox proportional hazards model for disease-specific survival revealed that expression of collagen XVIII (strongly positive versus negative; weakly positive versus negative), tumor classification, and regional lymph node classification were independent prognostic factors. CONCLUSIONS: Our results suggest that expression of collagen XVIII in tumor tissue is strongly associated with a poorer outcome in NSCLC and correlates with elevated levels of circulating serum endostatin.     

Circulating angiogenic cytokines in patients with advanced non-small cell lung cancer: correlation with treatment response and survival

Tumor angiogenesis is stimulated by a pro-angiogenic shift in both inducers and inhibitors of endothelial growth. To study this shift, we measured serum and plasma levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), endostatin, and thrombospondin 1 (TSP1) in 21 advanced non-small cell lung cancer (NSCLC) patients and 46 healthy control subjects. In addition, we assessed the relevance of these levels to disease outcome. Cytokine levels were prospectively measured in plasma and serum by enzyme-linked immunosorbent assay at three times: before chemotherapy and at 1 and 12 weeks following initiation of chemotherapy. In NSCLC patients, serum VEGF levels (sVEGF) were elevated (p<0.001), whereas serum and plasma TSP1 levels were lower (p=0.012 and p=0.004, respectively) than in healthy control subjects. Pretreatment plasma endostatin and serum bFGF levels were higher in NSCLC patients than in healthy controls (p=0.05 and 0.01, respectively). Change in sVEGF at week 12 after initiation of chemotherapy correlated with response to therapy (p=0.002). Patients with pretreatment sVEGF levels <500 pg/mL had a median survival of 11 months, but those with sVEGF >500 pg/mL had only a 6 months' median survival (p < 0.03). In NSCLC patients, VEGF levels are increased, whereas TSP1 levels are decreased, which may trigger and sustain tumor angiogenesis. High levels of serum VEGF at the time of presentation with NSCLC may predict worse survival.     

非小细胞肺癌CYFRA21-1和VEGF及PDGF联合检测的意义

 【摘要】　目的　探讨联合检测血清细胞角蛋白片段19（CYFRA21-1）、血管内皮生长因子（VEGF）和血小板衍生生长因子（PDGF）对非小细胞肺癌（NSCLC）诊断和分期的指导作用。方法　NSCLC患者及健康对照组血清CYFRA21-1采用电化学发光法测定，VEGF及PDGF采用双抗体夹心ABC-ELISA法测定。结果　NSCLC组CYFRA21-1、VEGF及PDGF测定值均高于正常对照组（P＜0.005）。血清CYFRA21-1、VEGF和PDGF测定值与NSCLC分期有关（P＜0.05）。血清CYFRA21-1测定值与病理分型有关（P＜0.05），血清VEGF和PDGF测定值与病理分型无关（P＞0.05）。血清CYFRA21-1、VEGF与PDGF测定值之间呈正相关（P＜0.01）。结论　CYFRA21-1、VEGF及PDGF的联合检测对NSCLC的诊断和分期具有一定的临床指导意义。     

Serum HE4 as a diagnostic and prognostic marker for lung cancer

We evaluated the diagnostic and prognostic efficacy of human epididymis protein 4 (HE4) for lung cancer patients by using our novel enzyme-linked immunosorbent assay (ELISA) system. We measured serum HE4 levels of cancer patients including 49 lung cancer and 18 ovarian cancer patients. Furthermore, we evaluated the relationship between serum HE4 levels and overall survival after chemotherapy of 24 lung cancer patients. Serum HE4 levels were significantly higher for non-small, small cell lung cancer and ovarian cancer patients than for healthy controls. The area under the receiver operating characteristic curve (AUC) was calculated for differentiation of lung cancer patients and healthy controls. AUC for serum HE4 was 0.988 for differentiating lung cancer patients from healthy controls, with a cutoff value of 6.56 ng/ml (sensitivity = 89.8%, specificity = 100%). Serum HE4 levels were elevated in 36/40 (90.0%) non-small cell lung cancer patients, 8/9 (88.9%) small cell lung cancer patients and 8/18 (44.4%) ovarian cancer patients. High levels of serum HE4 (>15 ng/ml) after chemotherapy were significantly correlated with worse overall survival after the treatment. These findings suggest that serum HE4 is a potential diagnostic and prognostic marker for lung cancer patients.     

Elevated vascular endothelial growth factor (VEGF) serum levels in idiopathic myelofibrosis.

An increase of angiogenesis has been shown in idiopathic myelofibrosis with myeloid metaplasia (MMM) by microvessel density count method but evaluation of circulating angiogenic factors is still incomplete. In 31 patients affected by MMM and in 12 healthy subjects we evaluated the serum levels of VEGF (vascular endothelial growth factor) and correlated VEGF with clinical and laboratory features of disease. We found that MMM patients had circulating VEGF concentrations much higher than controls (Median 1208 ng/ml vs 138 ng/ml, P < 0.0001). No correlation was found between VEGF and Hb, WBC, PLT, LDH, creatinine, bone marrow cellularity, fibrosis, splenomegaly, hepatomegaly, and therapy. However, in the subgroup of patients with a normal or low VEGF concentration, a direct correlation between VEGF and platelet count (r = 0.90, P = 0.002) was detected. Moreover, patients with a platelet count < 300 x 10(9)/l had VEGF serum levels lower than patients with a higher PLT count (median VEGF 864 vs 1557 pg/ml, P = 0.001). In six patients and in eight controls we also had the opportunity to measure VEGF in the plasma and we calculated that VEGF concentration was much higher in platelet-rich than in platelet-poor plasma and that platetets of MMM patients contained four times more VEGF than those of healthy controls. These results indicate that VEGF is overproduced in MMM, thus confirming an increased angiogenic activity. Platelets are probably a major source of VEGF in MMM but not the only one.     

内皮抑素在肺癌患者外周血清及支气管肺泡灌洗液中的表达研究

 目的 探讨内皮抑素（Endostatin）在肺癌患者外周血清及支气管肺泡灌洗液（Bronchoalveolar lavage fluid，BALF）中的表达以及与肺癌临床病理生理特征的关系。方法 采用酶联免疫吸附法（Enzyme-linked immunosorbent assay，ELISA）检测初诊肺癌47例及肺良性病变18例患者外周血清及BALF中Endostatin的表达水平。结果 肺癌患者外周血清及BALF中Endostatin分别为（131．71±50．32）ng／ml和（502．56±302．00）ng／ml，显著高于肺良性病变者（P〈0．01）；肺癌晚期、有淋巴结及远处转移、肺腺癌患者外周血清及BALF中Endostatin高表达；肺癌患者Endostatin在外周血清及灌洗液中的表达呈线性正相关（P=0．000）。结论 检测外周血清及支气管肺泡灌洗液中Endostatin均有助于肺癌的诊断及较好提示其生物学行为。     

Serum endostatin and bFGF as predictive factors in advanced breast cancer patients treated with letrozole

Introduction To investigate the value of baseline serum levels of VEGF, bFGF, endostatin and their ratio as predictive factors of response to endocrine therapy in patients with metastatic breast cancer (MBC) and positive ER treated with letrozole after tamoxifen failure. Materials and method The serum levels of endostatin, VEGF and bFGF were determined in post-menopausal patients with progressing MBC from serum samples obtained before initiation of letrozole. The relation between serum angiogenic factor levels and TTP was investigated. Results Seventy-six patients (45.2%) presented a high endostatin level (>24.6 ng/ml), 40% low bFGF levels (0 pg/ml) and 50.4% low VEGF (≤187 ng/ml). With a median follow-up of 22 months, the median TTP was 12.3 months. Median TTP was worse in patients with high endostatin concentration as well as in the low bFGF group, but was not affected when VEGF was considered. When the two factors were combined, the median TTP of patients with endostatin >24.6 ng/ml and bFGF equal 0 pg/ml was 9.5 months versus 19.5 months in patients with endostatin ≤24.6 ng/ml and bFGF>0 pg/ml. Conclusions The baseline levels of bFGF and endostatin are predictive factors of efficacy in patients with MBC treated with letrozole and can select groups with different TTP.     

肺癌患者血清中血管内皮生长因子的表达及其临床意义

目的:采用ELISA法检测肺癌患者血清血管内皮生长因子（VEGF）含量变化,以探讨其改变与肺癌临床诊断以及预后的关系。方法:原发性肺癌患者50例,取空腹静脉血4ml,采用酶联免疫吸附法(ELISA)测定血清中VEGF的水平,同时检测肺良性病变及健康体检者各50例,分别作为良性对照组及健康对照组。结果:肺癌组VEGF表达水平明显高于肺良性疾病组和健康对照组,有统计学意义（P＜0.05）;小细胞肺癌高于非小细胞肺癌,淋巴结转移者高于无转移者,差异均显著（P＜0.05）;且依TNM分期的早晚呈上升趋势,即:VEGF水平Ⅳ期＞Ⅲ期＞Ⅱ期＞Ⅰ期,组间差异显著（P＜0.05）;而血清VEGF水平与患者生存期呈负相关(r=-0.38,P＜0.05)。结论:检测肿瘤患者血清中VEGF的水平变化,对于肺癌的诊断和预后具有重要意义。