肺腺癌合并恶性胸腔积液患者血管生成素-2与胸腔积液局部控制及预后的关系

目的 探讨胸腔积液及血清中血管生成素-2（Ang-2）与肺腺癌合并恶性胸腔积液（MPE）患者胸腔积液局部控制及预后的关系。方法 收集肺腺癌合并MPE患者的胸腔积液及血液标本，采用ELISA法测定胸腔积液和血清中Ang-2水平，分析其与临床病理特征、胸腔积液局部控制情况及预后的关系。结果 胸腔积液和血清Ang-2水平分别为（26.67±8.82）pg／ml和（361.18±97.58） pg／ml。采用ROC曲线分析，当截断值为25.57 pg／ml时，胸腔积液Ang-2水平预测胸腔积液局部控制情况效能为最佳。Logistic回归分析显示胸腔积液Ang-2水平是胸腔积液局部控制情况的独立因素（OR=5.65，95%CI：2.40～16.78，P<0.001）。Cox多因素分析表明胸腔积液Ang-2水平（HR=1.15， 95%CI：1.01～1.32） 及胸腔积液局部控制情况（HR=0.42，95%CI：0.19～0.89）是影响肺癌合并MPE患者生存预后的独立因素。血清Ang-2水平与胸腔积液局部控制情况及预后无关（P＞0.05）。结论 胸腔积液Ang-2水平可作为肺腺癌合并MPE患者预测胸腔积液局部控制及判断预后的分子标志物，具有重要的临床应用价值。

Role of angiopoietin-2 in the control of malignant pleural effusion and prognosis in patients with primary lung adenocarcinoma

Objective To investigate the role of angiopoietin-2 （Ang-2） in control of malignant pleural effusions （MPE） and prognosis in patients with primary lung adenocarcinoma. Methods Using enzyme-linked immunoadsorbentassay， the levels of Ang-2 were measured in both pleural effusions （PE） and serum from a total of 79 lung adenocarcinoma patients with MPE. Data was analyzed with the efficacy of MPE control and prognosis. ResultsThe level of Ang-2 in PE was （26.67±8.82）pg／ml， and （361.18±97.58）pg／ml in serum. Ang-2 level in PE was the only one significant factor for MPE control when comparing with other demographic and laboratory data. Ang-2≥25.57 pg／ml in PE was used as a cut-off point for failure control of MPE. Logistic regression analysis showed that the level of Ang-2 in PE was an independent factor in the local control of PE（OR=5.65，95%CI：2.40-16.78，P<0.001）. In a multivariate analysis， the level of Ang-2 in PE （HR=1.15，95%CI：1.01-1.32） and MPE control status （HR=0.42， 95%CI：0.19-0.89） were confirmed as independent prognostic factors for overall survival. Conclusion The level of Ang-2 in PE appears to be a reliable surrogate marker in evaluating the therapeutic efficacy in the control of MPE and prognosis.