恶性脑胶质瘤患者VEGF及TGF-β的表达改变及其对瘤体可完整切除的判断价值  

Expression changes of transforming growth factor-β and vascular endothelial growth factor in malignant brain gliomas and their values in tumor resectability evaluation

作　　者：李钦涛[1] 齐平建[1] 董虹廷 

机构地区：[1]南阳市中心医院神经外科,473009

出　　处：《中华神经医学杂志》2018年第1期68-72,共5页Chinese Journal of Neuromedicine

摘　　要：目的观察恶性脑胶质瘤患者瘤体和外周血血管内皮生长因子（VEGF）及转化生长因子LB（TGF-β）的表达及其对瘤体可完整切除的判断价值。方法选泽南阳市中心医院神经外科自2010年1月至2017年1月行手术治疗的恶性脑胶质瘤患者188例（病例组），术中留取病例组患者肿瘤及瘤旁组织，采用Westem blotting检测患者肿瘤及瘤旁组织VEGF及TGF-β蛋白的表达。另选择同期体检的健康体检者50例（对照组），取对照组受试者及病例组患者术前24h外周血，采用酶联免疫吸附实验（ELISA）检测血清中VEGF及TGF-β水平，受试者工作特征（ROC）曲线分析患者术前外周血TGF-β及VEGF水平对胶质瘤能否完全切除的预测价值。结果恶性脑胶质瘤患者瘤体TGF-β及VEGF蛋白的表达均高于瘤旁组织，差异有统计学意义（P〈0．05）。病例组患者外周血TGF-β及VEGF水平均高于对照组，差异均有统计学意义（P〈0．05）。病例组患者中有126例患者瘤体完全切除，62例患者瘤体部分切除。术后随访1年，瘤体完全切除患者中死亡22例（17．46％），瘤体部分切除患者中死亡20例（32．26％）。瘤体完全切除患者术后1年累积死亡率低于瘤体未完全切除患者，差异有统计学意义（P〈0．05）。ROC曲线分析显示，以588．0prdmL为分界点，VEGF预测恶性脑胶质瘤无法完全切除的敏感性为80．65％，特异性为80．16％，曲线下面积为0．82，优于TGF-β。结论恶性脑胶质瘤患者术前外周血VEGF及TGF-β水平均升高，其中VEGF水平对判断瘤体是否可完整切除具有较高的价值。Objective To analyze the expression changes of transforming growth factor-β （TGF-β） and vascular endothelial growth factor （VEGF） in malignant brain gliomas and their values in tumor resectability evaluation. Methods One hundred and eighty-eight patients with malignant brain gliomas received surgery in our hospital from January 2010 to January 2017 were chosen in our study as patient group; during the surgery, the glioma tissues and peritumoral tissues were collected; Western blotting was employed to detect the VEGF and TGF-β expressions. Filly healthy controls accepted healthy examinations at the same time-period were enrolled. Peripheral blood 24 h before surgery of the two groups was collected. ELISA was used to test the serum VEGF and TGF-β levels. The values of serum VEGF and TGF-β levels in tumor resectability were analyzed by receiver operating characteristic （ROC） curve. Results In the patient group, significantly higher levels of VEGF and TGF-β in the tumor tissues were noted as compared with those in the para-tumor tissues （P〈0.05）. Significantly higher levels of VEGF and TGF-β in the patient group were noted as compared with those in the control group （P〈0.05）. There were 126 patients received total tumor resection, while 62 just had partial tumor resection; one year after surgery, 22 patients with total tumor resection （17.46%） died, and 20 patients with partial tumor resection （32.26%） died, which indicated that the cumulative mortality rate one year after surgery in patients with total tumor resection was significantly lower than that in patients with partial tumor resection （P〈0.05）. With cut-off point value of 588.0 pg/mL, ROC analysis showed that the sensitivity of VEGF in prediction of total tumor resection was 80.65%, and specificity 80.16%, and area under curve 0.82, which were better than those of TGF-β. Conclusion For malignant brain glioma patients, the levels of VEGF and TGF-β increase, and VEGF shows an ideal value in tumor resectability eval

关 键 词：神经胶质瘤 血管内皮生长因子 转化生长因子Β 预后 诊断 

分 类 号：R730.264[医药卫生—肿瘤]