| 王坚,汪建林,于静萍,孙志强,孙威,聂斌,倪新初,孙苏平,吴昌平.食管癌放化疗中血清血管内皮生长因子连续检测及其临床意义[J].中华放射医学与防护杂志,2016,36(4):278-282 |
| 食管癌放化疗中血清血管内皮生长因子连续检测及其临床意义 |
| Clinical significance of continuous detection of VEGF in patients undergoing chemoradiotherapy for esophageal carcinoma |
| 投稿时间：2016-01-04 |
| DOI：10.3760/cma.j.issn.0254-5098.2016.04.009 |
| 中文关键词: 食管癌 放化疗 血管内皮生长因子 预后 |
| 英文关键词:Esophageal carcinoma Chemoradiotherapy Vascular endothelial growth factor Prognosis |
| 基金项目:江苏省卫生厅指导性科研项目(Z201220) |
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| 中文摘要: |
| 目的 观察食管癌患者放化疗中血清血管内皮生长因子(VEGF)的变化规律,探讨其与预后的关系。方法 回顾性收集76例行根治性放疗的食管癌患者,其中53例行同期化疗,23例行单纯根治性放疗;放疗前、放疗中每周、放疗后1周内连续采集患者血清并测定VEGF水平,VEGF的变化分为上升组、不变组和下降组。另采集30例健康体检者血清并检测其VEGF水平为健康对照组。结果 全组患者1年总生存(OS)率、1年无进展生存(PFS)率分别为55.7%、51.4%,中位OS和PFS分别为13.4和12.5个月,复发13例。放疗中患者血清VEGF水平与放疗前比较呈逐渐下降趋势,差异有统计学意义(F=6.806,P=0.001);患者各时间点VEGF水平均高于健康对照组,差异均有统计学意义(t=2.165~3.896,P<0.05)。上升组、不变组和下降组1年OS率、1年PFS率比较,差异有统计学意义(χ2=6.811、6.602,P<0.05);3组患者局部控制(LC)率比较,差异无统计学意义(P>0.05)。OS、PFS、LC与放疗前血清VEGF无相关关系(r=-0.033、-0.056、0.090,P>0.05)。19例患者血清VEGF较放疗前升高,升高时间大多在放疗第2、3周或放疗后。结论 放化疗过程中血清VEGF变化可预测食管癌患者预后,放疗第2、3周和放疗后1周内检测可能对指导临床个体化治疗有重要意义。 |
| 英文摘要: |
| Objective To observe the serum vascular endothelial growth factor(VEGF) change, in order to explore its correlation with the prognosis of patients with esophageal carcinoma treated with chemoradiotherapy. Methods Seventy patients with esophageal carcinoma who were treated with radiotherapy including fifty-three patients with concurrent chemotherapy were enrolled. Serum levels of VEGF were detected before, during(per week) and after radiotherapy by enzyme-linked immunoabsorbent assay (ELISA) and accordingly divided into three groups:rising group,stable group and declining group. Serum VEGF level of 30 healthy subjects served as the control. Results For all patients,the 1-year overall survival(OS) rate and 1-year progression free survival(PFS) rate were 55.7% and 51.4%,respectively. The median values of OS and PFS were 13.4 and 12.5 months, respectively. Thirteen patients were recurrent. Compared with baseline level, the VEGF decreased with significant differences during radiotherapy(F=6.806,P=0.001). The VEGF levels before,during(per week) and after radiotherapy were significantly higher than control group(t=2.165-3.896,P<0.05).There were statistical differences of 1-year OS rate and 1-year PFS rate among different VEGF changing groups(rising group,stable group and declining group)(χ2=6.811, 6.602,P<0.05). However, the local control(LC)rate of the above three groups showed no obvious difference(P>0.05). The baseline VEGF level(before radiotherapy) had no influence on OS,PFS or LC(r=-0.033,-0.056,0.090,P>0.05).VEGF rised mostly in the second,third week during radiotherapy or one week after radiotherapy for nineteen VEGF rising patients. Conclusions The serum VEGF change during chemoradiotherapy could predict the prognosis of patients with esophageal carcinoma. To monitor the VEGF levels in the second, third week during radiotherapy or one week after radiotherapy might have important value on individualized treatment for esophageal carcinoma patients. |
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