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目的以无进展生存率为主要观察指标,探讨食管癌患者血清血管内皮生长因子(S- VEGF)表达水平与临床因素间的关系及其对预后影响。方法按入组条件共收治了89例食管癌患者,其中手术治疗46例,同期放化疗43例,同时选取30名健康人作为对照。手术采用食管病变切除术加区域淋巴结清扫术；同期放化疗的放疗剂量为60 Gy,照射方式采用常规分割方案；同期化疗方案为顺铂+氟尿嘧啶,分别在放疗开始的第1、29天进行。所有患者在治疗前取血清标本,应用S-VEGF定量试剂盒进行酶联免疫吸附试验。结果食管癌组治疗前S-VEGF表达水平明显高于正常对照组,分别为(475．93±44．76)、(294．20±23．40)pg/ml,差异有统计学意义(t=2．35,P=0．020)。S-VEGF表达水平受T分期和临床分期影响。Ⅰ+Ⅱ期和Ⅲ+Ⅳ期的1年无进展生存率分别为71%、29%(x~2 =10．12,P=0．002)。S-VEGF表达水平＜475 pg/ml和≥475 pg/ml的1年无进展生存率分别为66%、24%(x~2=12．31,P=0．000)。Cox回归分析结果表明S-VEGF表达水平也是影响预后的因素。结论治疗前食管癌患者S-VEGF表达水平明显高于健康人,S-VEGF表达水平受临床分期影响。食管癌患者治疗前S-VEGF表达水平影响患者预后,有可能作为一个独立预后指标。
Objective To investigate the relationship between the expression of serum vascular endothelial growth factor (S-VEGF) and clinical factors and its prognostic significance in progression-free survival rate. Methods A total of 89 patients with esophageal cancer were enrolled according to the conditions of the patients. Among them, 46 patients were treated by surgery and 43 patients were treated by chemoradiotherapy during the same period. Thirty healthy people were selected as control. Surgery with esophagectomy plus regional lymph node dissection; the same period of radiotherapy and chemotherapy radiotherapy dose of 60 Gy, irradiation method using conventional partition scheme; the same period of chemotherapy for cisplatin + fluorouracil, respectively, in the first and second days of radiotherapy 9 days. Serum samples of all patients before treatment, the application of S-VEGF quantitative kit for enzyme-linked immunosorbent assay. Results The expression of S-VEGF in esophageal cancer group was significantly higher than that in the normal control group (475.93 ± 44.76, 294.20 ± 23.40, pg / ml respectively), the difference was statistically significant (t = 2.35, P = 0.020). The level of S-VEGF expression is affected by T stage and clinical stage. The 1-year progression-free survival rates for stage I + II and stage III + IV were 71% and 29%, respectively (x 2 = 10.12, P = 0.002). The 1-year progression-free survival rates for S-VEGF expression levels <475 pg / ml and ≥475 pg / ml were 66% and 24%, respectively (x 2 = 12.31, P = 0.000). Cox regression analysis showed that the expression level of S-VEGF is also a prognostic factor. Conclusion The expression of S-VEGF in esophageal cancer patients before treatment is obviously higher than that in healthy people. The expression level of S-VEGF is affected by clinical stage. The expression of S-VEGF in esophageal cancer patients before treatment affects the prognosis of patients, which may be used as an independent prognostic indicator.