首页|血清VEGF与CEA检测在肺癌患者免疫联合治疗疗效评估中的价值

血清VEGF与CEA检测在肺癌患者免疫联合治疗疗效评估中的价值

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目的 探讨血管内皮生长因子(VEGF)、癌胚抗原(CEA)水平作为肺癌免疫联合治疗疗效评价指标的临床价值.方法 纳入2019年6月-2022年6月本院收治的100例确诊非小细胞肺癌(NSCLC)患者,随机分为观察组(免疫联合化疗或联合抗血管治疗)50例和对照组(放化疗治疗)50例.考察VEGF、CEA水平与免疫联合治疗两周期后近期疗效的关系.结果 观察组近期疗效优于对照组(客观缓解率:40%vs 22%),但差异无统计学意义(P<0.05).进一步分组分析发现,仅免疫联合抗血管治疗患者疗效显著提升(56%vs22%).单因素分析发现:观察组患者基线VEGF、CEA水平与近期疗效显著相关.而对两组患者治疗前后血清VEGF、CEA水平分析发现,与治疗前相比,治疗有效患者VEGF含量均显著下降(P<0.05),但观察组中免疫联合抗血管治疗有效患者CEA水平无显著变化.对血清学指标与免疫联合治疗近期疗效行多因素分析,发现仅VEGF下降率与疗效显著相关(HR=0.085,95%CI为0.009~0.857,P<0.05).治疗后VEGF水平下降>20%的免疫联合化疗患者中,44%显示治疗有效;VEGF水平下降>20%的免疫联合抗血管治疗患者,80%显示治疗有效.结论 免疫联合治疗患者相较放化疗有更好的近期疗效,治疗有效患者VEGF水平显著降低.治疗两周期后VEGF下降率对患者免疫联合治疗,尤其是免疫联合抗血管治疗的近期疗效具有潜在预测作用,有望作为此类药物临床策略开发的敏感指标,并指导药物的合理使用.
The predictive value of vascular endothelial growth factor and CEA markers for immunotherapyinlung cancer
Objective The aim of this study was to evaluate the clinical value of VEGF、CEA levels for immuno-therapy in lung cancer.Methods A total of 100 patients with confirmed NSCLC were enrolled and randomly divided into observation group(immune combined with chemoradiotherapy or immune combined with antivascular therapy,n=50)and the control group(chemoradiotherapy,n=50).The relationship between the level of VEGF,CEA and the short-term efficacy of immunotherapy after two cycles of treatment was investigated in this study.Results The short-term cur-ative effect of the observation group was better than that of the control group,and the objective remission rate was higher(40%vs 22%),but there was no significant difference(P<0.05).Further analysis showed that the efficacy was signifi-cantly improved in patients treated with immunotherapy alone(56%vs 22%).A univariate analysis showed that the ser-um levels of VEGF and CEA at baseline were significantly correlated with the short-term outcome.The dynamic monito-ring of serum VEGF and CEA in the two groups before and after treatment showed that the levels of VEGF in the effec-tive patients were significantly lower than those before treatment(P<0.05),however,the CEA level of the patients with immune combined with anti-vascular therapy had no significant change.In addition,multivariate analysis showed the rate of VEGF decline was significantly related with the short-term efficacy(HR=0.085,95%CI0.009-0.857,P<0.05).44%patients who received immunotherapy combined with chemoradiotherapy showed benefit with VEGF level decreasing more than 20%,while 80%patients who received immunotherapy combined with antivascular therapy showed benefit.Conclusion The better short-term efficacy is from immunotherapy compared with radiotherapy.Serum VEGF levels is significantly reduced in in lung cancer patients with effective immunotherapy.The decrease rate of VEGF after two cycles of treatment is a potentialpredict marker for the short-term efficacy of immunotherapy,which may be used as a sensitive tool for the development of clinical strategies of this kind of drugs.

Non-small cell lung cancerVEGFCEARadiochemotherapy combined with immunotherapyPre-dictive value

贺敏、赵惠临、杨晓斌、郭佳、刘书颖、尹杰荣、程磊、黄晓玲

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临汾市中心医院检验科,山西临汾 041000

临汾市中心医院肿瘤科,山西临汾 041000

临汾市中心医院放射科,山西临汾 041000

临汾市中心医院病理科,山西临汾 041000

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非小细胞肺癌 血管内皮生长因子 癌胚抗原 免疫联合治疗 疗效评估

2025

西部医学
四川

西部医学

影响因子:1.352
ISSN:1672-3511
年,卷(期):2025.37(1)