鼻咽癌放射治疗前测定血管内皮生长因子的意义.DOCVIP

临床医学论文-鼻咽癌放射治疗前测定血管内皮生长因子的意义 【关键词】? 鼻咽癌 ??? ［摘要］? 目的：于放疗前后检测鼻咽癌患者血清中血管内皮生长因子（vascular endothelial growth factor, VEGF）和β2微球蛋白的水平，探讨其变化及临床意义。方法：采集58例鼻咽癌患者和24名健康体检者血清，应用酶联免疫吸附法（enzymelinked immunosorbent assay, ELISA）测定VEGF水平，用时间分辨荧光免疫分析(timeresolved fluoroimmunoassay, TRFIA)方法测定β2微球蛋白水平，并对其变化及其与临床分期和患者生存期的关系进行分析。结果：鼻咽癌患者治疗前血清VEGF水平为（174.0±130.0）ng/L，稍高于健康体检者的（134.1±66.6）ng/L，但差异无统计学意义（P0.05）。鼻咽癌TNM分期T4和临床分期Ⅳa患者治疗前血清VEGF水平较高。治疗前血清VEGF水平267.3 ng/L者，无远处转移生存期短（P0.05）。β2微球蛋白水平高的患者，中位生存期短，但差异无统计学意义。结论：鼻咽癌治疗前VEGF水平明显升高提示预后不良。 　　［关键词］? 鼻咽癌; 放疗; 血管内皮生长因子; β2微球蛋白 　　Significance of serum vascular endothelial growth factor test before radiotherapy in patients with nasopharyngeal carcinoma 　　ABSTRACT? Objective: To study the changes of serum vascular endothelial growth factor (VEGF) and beta 2microglobulin levels before and after radiotherapy in 58 patients with nasopharyngeal carcinoma (NPC), and to elucidate the clinical significance of VEGF and beta 2microglobulin test before radiotherapy. Methods: Serum VEGF level was measured by sandwich ELISA in 58 patients with NPC and 24 healthy individuals, and the serum beta 2microglobulin was assayed with timeresolved fluoroimmunoassay. Results: The serum VEGF level in patients with NPC was (174.0?30.0) ng/L, higher than (134.1±66.6) ng/L of the healthy subjects, but the difference was not significant (P0.05). The serum VEGF level was higher in T4 and Ⅳ a patients with NPC. No significant differences in the levels of serum VEGF were found among various N classifications in the patients with NPC. Patients with the serum VEGF level higher than 267.3 ng/L (mean+2 s of the serum VEGF level in the healthy individuals) had a shorter metastasisfree survival time (P0.05). Although the patients with high beta 2microglobulin level had a shorter survival time, the difference was not significant. Conclusion: The NPC patients with high serum VEGF level have a poor prognosis.?　　KEY WORDS? nasopharyngeal carcinoma; radiotherapy; vascular endotheli