VEGFA和VEGFR2对肺腺癌患者术后无病生存的预测价值  

Prognostic value of VEGFA and VEGFR2 in disease-free survival of patients with lung adenocarcinoma receiving surgery

作　　者：袁晓晗[1] 杨杰[1] 秦婷婷[1] 李凯[1] 

机构地区：[1]天津医科大学肿瘤医院肺部肿瘤内科国家肿瘤临床研究中心天津市"肿瘤防治"重点实验室天津市恶性肿瘤临床医学研究中心,天津300060

出　　处：《肿瘤》2017年第7期716-722,共7页Tumor

基　　金：天津市科技计划课题(编号:13ZCZCSY20300;12ZCDZSY15600)~~

摘　　要：目的 :探讨血管内皮生长因子A(vascular endothelial growth factor A,VEGFA)和血管内皮生长因子受体2(vascular endothelial growth factor receptor 2,VEGFR2)与肺腺癌患者术后无病生存(disease-free survival,DFS)之间的相关性。方法:选择114例肺腺癌术后肿瘤组织标本,应用免疫组织化学法(immunohistochemistry,IHC)检测VEGFA及VEGFR2蛋白的表达情况。收集肺腺癌患者的性别、年龄、吸烟情况、肿瘤大小、阳性淋巴结(positive lymph nod,PLN)数目、临床分期和术后治疗情况等临床资料,分析VEGFA和VEGFR2与这些临床特征的相关性。COX比例风险回归模型分析影响肺腺癌患者术后DFS的相关因素。结果:IHC检测结果显示,VEGFA和VEGFR2在NSCLC患者肺腺癌组织中的阳性表达率均为46.49%(53/114)。VEGFA蛋白的表达与患者的临床特征无显著相关性,而VEGFR2蛋白的表达与肿瘤大小存在负相关(P=0.03)。单因素分析显示,VEGFA与VEGFR2蛋白的表达与患者DFS无显著相关性。肿瘤大小>4 cm(相对风险为2.29,95%可信区间为1.32~3.97;P=0.003)和PLN数≥2个(相对风险为2.15,95%可信区间为1.27~3.64;P=0.005)是肺腺癌患者术后DFS的独立危险因素。结论:VEGFA和VEGFR2蛋白的表达与肺腺癌患者术后DFS无显著相关性。肿瘤大小>4 cm和PLN数≥2个是肺腺癌患者术后DFS的独立影响因素。Objective： To evaluate the effects of vascular endothelial growth factor A （VEGFA） and vascular endothelial growth factor receptor 2（VEGFR2） on disease-free survival （DFS） of patients with lung adenocarcinoma receiving surgery. Methods： Immunohistochemistry （IHC） was performed to detect the expressions of VEGFA and VEGFR2 proteins in adenocarcinoma tissues from 114 patients after surgery.The information on clinical characteristics including gender,age,smoking status,tumor size,number of positive lymph nodes （PLNs）,clinical stage and treatment after surgery was collected,and the associations of VEGFA and VEGFR2 expressions with the clinical characteristics were analyzed.The COX proportional hazards regression model was used to identify the independent prognostic factors for DFS. Results： The IHC result showed that the positive rates of VEGFA and VEGFR2 expressions in adenocarcinoma tissue samples were 46.49%（53/114） and 46.49%（53/114）,respectively.There was no evidence indicating that VEGFA expression was significantly associated with the clinical characteristics of patients with lung adenocarcinoma,but VEGFR2 expression was significantly correlated with the tumor size （P=0.03）.COX proportional hazards regression model revealed that VEGFA and VEGFR2 expressions had no significant effects on patients＇DFS;the tumor size 〉 4 cm （relative risk：2.29;95% confidence interval：1.32-3.97;P=0.003） and the number of PLNs ≥ 2（relative risk：2.15;95% confidence interval：1.27-3.64;P=0.005） were independent factors to predict DFS of patients with lung adenocarcinoma after surgery. Conclusion： For patients with lung adenocarcinoma receiving surgery,VEGFA and VEGFR2 expressions have no significant correlation with DFS;the tumor size 〉 4 cm and the number of PLNs ≥ 2 may be the independent factors affecting DFS.

关 键 词：癌 非小细胞肺 肺腺癌 手术 血管内皮生长因子A 血管内皮生长因子受体2 无病生存 

分 类 号：R734.2[医药卫生—肿瘤]