摘要
目的 探讨乳腺癌手术切除患者放疗前后外周血血管内皮生长因子(vascular endothelial growth factor,VEGF)、血管细胞黏附分子-1(vascular cell adhesion molecule-1,VCAM-1)水平变化及临床意义.方法 前瞻性选择2022年6月至2023年6月济宁医学院附属医院进行治疗的110例行乳腺癌手术后拟行放疗的患者作为观察组,另选取同期健康体检志愿者110例作为对照组,比较所有受试者外周血VEGF、VCAM-1水平,观察组患者一般资料、肿瘤病理与外周血VEGF、VCAM-1水平的关系,并分析其与疾病预后的关系.结果 观察组外周血VEGF、VCAM-1水平均显著高于对照组(F=1 288.37、309.32,P＜0.05);放疗后,观察组外周血VEGF、VCAM-1水平显著低于放疗前(t=23.45、11.88,P＜0.05).放疗前后,观察组外周血VEGF、VCAM-1水平与肿瘤分期、肿瘤分化程度、Ki67增殖指数情况有关(t肿瘤分期=7.05、2.14、4.52、4.76,t肿瘤分化程度=7.12、6.62、2.81、3.15,tKi67增殖指数=7.25、4.60、4.24、2.48,P＜0.05).110 例观察组,有效 73 例,无效34例,有效组VEGF、VCAM-1显著低于无效组(t=7.27、9.08,P＜0.05).Spearman相关系数分析结果显示,放疗前后外周血VEGF、VCAM-1水平与肿瘤分期、Ki67增殖指数呈显著正相关(r放疗前=0.64、0.54、0.52、0.52,r放疗后=0.32、0.39、0.37、0.24,P＜0.05),与肿瘤分化程度呈显著负相关(r放疗前=-0.41、-0.31,r放疗后=-0.68、-0.41,P＜0.05).联合评估放疗预后价值AUC 为0.801[95％CI(0.714～0.871)],大于单独 VEGF、VCAM-1 的0.690[95％CI(0.595～0.775)]、0.734[95％CI(0.641～0.814)].结论 外周血VEGF、VCAM-1 水平变化对乳腺癌手术切除患者放疗短期预后存在一定评估价值.
Abstract
Objective To investigate the changes and clinical significance of vascular endothelial growth factor(VEGF)and vascular cell adhesion molecule-1(VCAM-1)levels in patients undergoing breast cancer re-section before and after radiotherapy.Methods A total of 110 patients who were treated in our hospital from Jun.2022 to Jun.2023 for breast cancer and were to receive radiotherapy after surgery were prospectively selected as the observation group.Another 110 healthy volunteers were selected as the control group.The levels of VEGF and VCAM-1 in peripheral blood were compared,and the relationship among general data,tumor pathology and periph-eral blood VEGF and VCAM-1 in the observation group was analyzed,and their relationship with disease and prog-nosis was analyzed.Results VEGF and VCAM-1 levels in peripheral blood in the observation group were signifi-cantly higher(F=1288.37,309.32,P＜0.05).The levels of VEGF and VCAM-1 in peripheral blood in the observa-tion group were significantly lower than before radiotherapy(t=23.45,11.88,P＜0.05).Before and after radiothera-py,VEGF and VCAM-1 levels in peripheral blood in the observation group were correlated with tumor stage,tumor differentiation degree and Ki-67 proliferation index(ttumor stage=7.05,2.14,4.52,4.76,ttumor differentiation degree=7.12,6.62,2.81,3.15,tKi67 proliferation index=7.25,4.60,4.24,2.48,P＜0.05);Of 110 patients in the observation group,73 were effec-tive and 34 were ineffective.VEGF and VCAM-1 in effective group were significantly lower(t=7.27,9.08,P＜0.05).Spearman correlation coefficient analysis showed that VEGF and VCAM-1 levels were significantly positive-ly correlated with tumor stage and Ki67 proliferation index before and after radiotherapy(rbefore radiotherapy=0.64,0.54,0.52,0.52,rafter rnadiotherapy=0.32,0.39,0.37,0.24,P＜0.05),and negatively correlated with tumor differentiation degree(rbefore radiotherapy=-0.41,-0.31,rafter radiotherapy=-0.68,-0.41,P＜0.05).The prognostic value of combined radiotherapy was 0.801[95％CI(0.714-0.871)],which was higher than that of VEGF and VCAM-1 alone 0.690[95％CI(0.5955-0.775)]and 0.734[95％CI(0.641-0.814)].Conclusion The changes of VEGF and VCAM-1 levels in peripheral blood have a certain value in evaluating the short-term prognosis of patients undergoing breast cancer resection by radiotherapy.
基金项目
2022年济宁市重点研发计划项目(2022YXNS050)
NETL
NSTL
万方数据