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目的探讨局部晚期NSCLC患者同步放化疗前后血清VEGF/血小板数和OPN的表达水平及变化的临床意义。方法 56例局部晚期NSCLC患者同步放化疗前采用ELISA法测定血清VEGF/血小板数和OPN的表达水平,然后行三维适形放疗,中后期重复CT定位缩野并对残存靶体积加量照射,至总DT60～64Gy,同步化疗采用顺铂25mg/m2,每周静脉滴注1次,连用5～6周。治疗结束后3周再次测定血清VEGF/血小板数和OPN的表达水平,并行胸部CT检查,根据CT结果分为疗效有效组(完全缓解+部分缓解)和疗效无效组(病情稳定+疾病进展)。结果同步放化疗前VEGF/血小板数、OPN在有效组(CR+PR)的表达水平分别为(0.83±0.14)10-6pg、(32.26±7.46)ng/ml,治疗后二者血清浓度明显下降,分别为(0.44±0.10)10-6pg、(25.46±2.21)ng/ml,差异均有统计学意义(t=23.10、4.89,P<0.05)。而无效组(SD+PD)VEGF/血小板数、OPN表达水平反而明显升高,VEGF/血小板数差异具有统计学意义(t=21.51,P<0.05)。结论局部晚期NSCLC患者同步放化疗前后血清VEGF/血小板数和OPN的表达水平可为疗效判断提供依据。
Objective To investigate the clinical significance of serum VEGF / platelet count and OPN expression in patients with locally advanced NSCLC before and after concurrent chemoradiotherapy. Methods Fifty-six patients with locally advanced NSCLC underwent chemoradiotherapy before the concurrent chemoradiotherapy. The serum levels of VEGF / platelet and OPN were measured by ELISA. Then three-dimensional conformal radiotherapy was performed. In the second and third trimester, Total DT60 ~ 64Gy, synchronous chemotherapy with cisplatin 25mg / m2, intravenous drip weekly 1, once every 5 to 6 weeks. Serum VEGF / platelet count and OPN expression levels were measured again 3 weeks after the end of treatment, and chest CT examination was performed. According to the results of CT, the patients were divided into two groups: effective group (complete remission + partial remission) and ineffective group (stable disease + disease progression). Results The expression of VEGF / platelet and the level of OPN in CR + PR were (0.83 ± 0.14) 10-6 pg and (32.26 ± 7.46) ng / ml, respectively, before and after concurrent chemoradiotherapy. , Respectively (0.44 ± 0.10) 10-6pg and (25.46 ± 2.21) ng / ml, the differences were statistically significant (t = 23.10,4.89, P <0.05). In the invalid group (SD + PD), VEGF / platelet count and OPN expression level increased significantly, while the difference of VEGF / platelet count was statistically significant (t = 21.51, P <0.05). Conclusions The serum levels of VEGF / platelet and OPN before and after concurrent chemoradiotherapy in patients with locally advanced NSCLC may provide a basis for judging the therapeutic effect.