Predictive value of serum TGF-β1 and VEGF levels in patients with non-small cell lung cancer after single-port thoracoscopic radical resection
Objective To analyze the predictive value of serum transforming growth factor-β1(TGF-β1)and vascular endothelial growth factor(VEGF)in patients with non-small cell lung cancer(NSCLC)after single-port thoracoscopic radical resection.Methods A total of 50 patients with NSCLC who underwent single-port thoracoscopic radical resection in Affiliated Hospital of Xuzhou Medical University from May 2018 to May 2020 were selected as the observation objects.Serum TGF-β1,VEGF levels and Karnofsky functional status(KPS)scores before and after surgery were compared,and the total incidence of complications was calculated.All subjects were followed up for 3 years,and serum levels of TGF-β1,VEGF and KPS scores were compared between relapsed group and non-relapsed group,survival group and death group.Pearson correlation analysis was used to explore the correlation between TGF-β1,VEGF and KPS scores.The receiver operator characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to evaluate the predictive value of serum TGF-β1 and VEGF alone and combined detection in patients with NSCLC after single-port thoracoscopic radical resection.Results The serum levels of TGF-β1 and VEGF were(7.16±1.94)μg/L and(42.26±5.04)ng/L in 50 patients with NSCLC one month after single-port thoracoscopic radical resection,which were lower than those before surgery[(13.62±3.52)μg/L and(136.52±20.66)ng/L,t=11.37,P＜0.001;t=31.34,P＜0.001].The KPS score one month after surgery was 66.57±8.11,which was higher than that before surgery(53.62±5.62,t=9.28,P＜0.001).Postoperative wound healing was delayed in 1 of the 50 patients,pulmonary infection in 1 patient,and no pulmonary embolism and other complications occurred.The total incidence of complications was 4.00％.The serum levels of TGF-β1 and VEGF in patients in the relapsed group(n=6)were(12.95±4.26)μg/L and(72.46±6.05)ng/L respectively,which were higher than those in the non-relapsed group(n=44)[(6.37±1.25)μg/L and(38.14±5.37)ng/L;t=8.34,P＜0.001;t=29.99,P＜0.001].The KPS score in the relapsed group was 52.16±8.16,which was lower than that in the non-relapsed group(67.55±12.67,t=2.88,P=0.006).Serum levels of TGF-β1 and VEGF in the death group(n=5)were(13.99± 6.82)μg/L and(75.95±9.05)ng/L,which were higher than those in the survival group(n=45)[(6.41± 3.06)μg/L and(38.52±8.37)ng/L;t=4.56,P＜0.001;t=21.47,P＜0.001].The KPS score in the death group was 1.25±0.34,which was lower than that in the survival group(65.11±12.94,t=10.93,P＜0.001).Pearson correlation analysis showed that serum levels of TGF-β1(r=-0.45,P＜0.001)and VEGF(r=-0.48,P＜0.001)were negatively correlated with KPS scores.ROC curve analysis showed that when the optimal cut-off value of TGF-β1 was 8.14 μg/L,the AUC for predicting recurrence after single-port thoracoscopic radical resection was 0.516(95％CI:0.446-0.676),the sensitivity was 71.85％,and the specificity was 80.69％.When the optimal cut-off value of VEGF was 142 ng/L,the AUC was 0.659(95％CI:0.534-0.761),the sensitivity was 76.04％,and the specificity was 82.52％.The AUC of the combined detection was 0.828(95％CI:0.786-0.951),the sensitivity was 91.86％,and the specificity was 87.52％.The AUC of combined detection was higher than that of serum TGF-β1(Z=2.63,P=0.007),VEGF(Z=2.32,P=0.013)single detection.Conclusion The serum levels of TGF-β1 and VEGF are significantly decreased in NSCLC patients after one month of single-port thoracoscopic radical resection,and the combined detection of the two has predictive value for recurrence after single-port thoracoscopic radical resection.
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