小细胞肺癌化疗前后血清VEGF和b-FGF的变化及临床意义

  目的  探讨化疗前后小细胞肺癌(SCLC)患者血清血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(b-FGF)水平的变化及临床意义。  方法  用酶联免疫吸附法测定34例SCLC患者化疗前后VEGF和b-FGF的浓度变化, 并与34例健康志愿者做对照。  结果  化疗前肺癌组VEGF及b-FGF水平均明显高于健康对照组, 差异有统计学意义(P < 0.001);化疗后有效组VEGF及b-FGF水平明显低于化疗前, 差异有统计学意义(P < 0.001);肺癌组VEGF和b-FGF水平无显著相关性; 相关性分析表明VEGF浓度的升高仅与化疗疗效和NSE升高相关(P < 0.05), b-FGF的升高与各项病理特征均无显著相关性(P > 0.05);Kaplan-Meier生存分析证实VEGF和b-FGF低浓度组的平均生存期均明显长于高浓度组(P < 0.05)。  结论   SCLC患者血清VEGF和b-FGF浓度与生存明显相关, 可以作为SCLC患者生存的预后因子。此外, 化疗前后血清VEGF和b-FGF浓度变化可以作为预测SCLC患者化疗疗效的指标。 

Clinical significance of serum vascular endothelial growth factor and b-fibroblast growth factor before and after chemotherapy in patients with small cell lung cancer

  Objective  This study evaluated the changes in the levels of serum vascular endothelial growth factor(VEGF) and b-fibroblast growth factor(b-FGF) and their clinical significance in patients with small cell lung cancer(SCLC) before and after chemotherapy.  Methods  Serum VEGF and b-FGF were measured in 34 patients with SCLC using ELISA, and the results were compared with measurements from healthy volunteers.  Results  A significant difference was found in the serum VEGF and b-FGF levels between the patients with SCLC and the healthy volunteers(P < 0.01).The serum VEGF and b-FGF levels of the effective treatment group decreased after chemotherapy(P < 0.01), whereas no significant difference was found in the ineffective treatment group before and after chemotherapy(P > 0.05).No statistically significant relationship was found between the serum VEGF and the b-FGF levels.Considering the median concentration of serum VEGF and b-FGF as a cut-off, the correlation analysis showed that the elevated VEGF level was correlated only with poor efficacy of chemotherapy and the increase in neuron-specific enolase(P < 0.01).The high b-FGF level has no significant correlation with any pathological characteristic(P > 0.05).Resultsfrom the Kaplan-Meier survival analysis showed that patients with low-level VEGF or b-FGF had significantly longer over-all survival time than those with high-level VEGF or b-FGF(P < 0.01).  Conclusion  Significant correlation was found between the survival of patients with SCLC and the serum VEGF or b-FGF level.Therefore, serum VEGF and b-FGF may be used as prognostic factors for survival and as indicators in predicting the efficacy of chemotherapy in patients with SCLC.