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  

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

作　　者：钱倩[1] 胡韡[1] 

机构地区：[1]南京胸科医院呼吸科,南京210029

出　　处：《临床肿瘤学杂志》2017年第10期903-907,共5页Chinese Clinical Oncology

基　　金：国家自然科学基金青年科学基金项目(81500073)

摘　　要：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。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. Results The 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 la- boratory 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 re- liable surrogate marker in evaluating the therapeutic efficacy in the control of MPE and prognosis.

关 键 词：肺癌 恶性胸腔积液 血管生成素-2 疗效评价 预后 

分 类 号：R734.2[医药卫生—肿瘤]