血管内皮生长因子表达与食管癌同期放化疗预后关系  

The expression of serum vascular endothelial growth factor and its prognostic significance in esophageal carcinoma after chemoradiotherapy

作　　者：陈德玉[1] 张琴[1] 刘俊[1] 陈传生[1] 李君荣[2] 闻平[1] 

机构地区：[1]江苏大学附属医院放疗科,江苏镇江212001 [2]江苏大学医学院统计学教研室,江苏镇江212001

出　　处：《中国癌症杂志》2006年第4期287-289,共3页China Oncology

基　　金：江苏省卫生厅计划性项目(H200355)。

摘　　要：背景与目的血清血管内皮生长因子(S-VEGF)在多种实体瘤表达报道较多,然而S-VEGF与放化疗预后关系临床研究甚少。本研究探讨食管癌同期放化疗预后与血管内皮生长因子表达关系和临床意义。方法70例中上段食管癌患者随机分为两组,研究组35例接受同期放化疗,对照组35例接受单纯放射治疗。应用酶联免疫吸附法(ELISA)检测两组患者治疗前、后血清血管内皮生长因子(S-VEGF)水平。采用Kaplan-Meier法计算两组生存率,χ2和Log-rank法检测两组观察指标差异,分析其与疗效的关系及临床意义。结果治疗后两组患者S-VEGF水平均有显著降低[治疗组由(548.65±253.94)pg/ml降低为(191.29±159.24)pg/ml(P<0.001)];对照组[由(622.83±231.47)pg/ml降低为(412.26±263.86)pg/ml(P<0.001)]。与对照组相比,治疗组治疗后S-VEGF表达水平下降更显著(P<0.001);研究组和对照组1、2、3年生存率分别为79.4%、59.8%、47.6%和54.3%、30.6%、20.1%,治疗组1、2、3年生存率均显著高于对照组(P<0.05)。结论食管癌患者放射治疗后S-VEGF水平较治疗前显著降低;同期放化疗较单纯放疗后的S-VEGF水平显著降低;同期放化疗能显著提高患者长期生存率。Background and purpose： An increase in the serum VEGF（S-VEGF） concentration has been found in patients with various solid tumors. To our knowledge, data concerning the significance of S-VEGF in the patient response to chemoradiotherapy have rarely been reported to date. We studied the expression of serum vascular endothelial growth factor and its prognostic significance in esophageal carcinoma after chemoradiotherapy. Methods： Seventy patients with upper and middle esophageal cancer were randomized into two groups where 35 received concurrent chemoradiotherapy （CRT） and 35 received radiotherapy （RT） alone. S-VEGF was measured by enzyme-linked immunoadsorbent assay （ELISA） in both groups before treatment and 1 month after treatment. Then, the correlation between the expression of S-VEGF and its association with clinical significance and response rate to concurrent chemuradiotherapy in esophageal carcinoma were evaluated. Survival rate was calculated with Kaplan-Meier method. Chi and Log-rank test were used to assess the significant difference between the two groups. Results： S-VEGF levels were affected before and after treatment, the expression of S-VEGF was 548.65253.94 pg/ml versus 191.29159.24pg/ml （P 〈 0.001） before and after chemoradiotberapy and 622.83±231.47 pg/ml versus 412.26±263.86 pg/ml （P 〈 0.001） before and after radiotherapy. The change of S-VEGF level was more significant in CRT than in RT before and after treatment （test P 〈0.001）. 1-, 2-, 3-year survival rates were 79.4%, 59.8% and 47.6% for CRT and 54.3%, 30.6%, 20.1% for RT, respectively. Significant improvement in the long-term survival rate was observed in CRT group. Conclusions： S-VEGF levels are significantly reduced in patients with esophageal cancer after radiotherapy. The patients who received concurrent chemoradiotberapy showed significantly less S-VEGF than those patients who received radiotherapy alone. Thus chemoradiotherapy can improve long-term survival of esophageal carcinoma.

关 键 词：食管肿瘤 放射疗法 血清血管内皮生长因子 放化疗同步疗法 预后 

分 类 号：R735.1[医药卫生—肿瘤]