The Clinical Significance Of The Changes Of Serum VEGF And Endostatin In Patients With Advanced Non-small Cell Lung Cancer Treated By Chemotherapy

BackgroundWith the impact of industrialization, air pollution, smoking and various biochemical factors, lung cancer had become the fastest growing malignant tumor of morbidity and mortality in China, which produced a huge threat to human health and life. Radiotherapy and chemotherapy was the primary means of treatment of advanced lung cancer, however, the overall survival was short. After the third-generation chemotherapy drugs, treatment entered the bottleneck time, finding new targets and direction had become a hot spot of the contemporary study of lung cancer.In recent years, tumor angiogenesis in lung cancer had made a lot of progress, to find that tumor growth and metastasis depended on many factors, including the two systems to stimulate angiogenesis and inhibition of angiogenesis, VEGF and Endostatin are important factors in these two systems respectively, which was also a research hotspot in recent years.Lung cancer had high expression of VEGF and Endostatin confirmed through experiments, but advanced patient was not easy to obtain pathological specimens, and testing the serum VEGF and Endostatin was relatively simple, which could be observed dynamically.ObjectiveBy testing serum VEGF and Endostatin levels before and after chemotherapy of advanced non-small cell lung cancer patients, we could observe the relationship with the efficacy, and the relationship between clinical pathophysiology of non-small cell lung cancer and VEGF, Endostatin, analyze the correlation and prognosis between the two groups.MethodsDetecting serum VEGF and Endostatin levels of45advanced non-small cell lung cancer patients before chemotherapy and after two cycles of chemotherapy quantitatively by double antibody sandwich enzyme-linked immunosorbent assay, we could analyze each factor changes and clinical significance, simultaneously detect serum VEGF and Endostatin levels of20healthy controls, and adopt SPSS13.O statistical software for statistical analysis.ResultsThis study shows that serum VEGF level of advanced NSCLC patients was (668.93±152.32) pg/ml, in healthy people group (115.54±23.27) pg/ml and there was significant difference (p=0.000); serum ES level of advanced NSCLC patients was (111.95±45.64)ng/ml, in healthy people group (52.82±8.71)pg/ml and there was significant difference (p=0.000). The result shows that serum VEGF and ES levels of advanced NSCLC patients have no relation with age、sex、smoking and pathological type (p>0.05); serum VEGF level has relation with stage. Serum VEGF level of IV stage patients was (714.53±150.25)pg/ml and was significantly higher than IIIB stage patients (587.90±126.14) pg/ml(P=0.0058); serum ES level has relation with staging and serum ES level of ⅢB stage patients was(130.32±35.30)pg/ml and was significantly higher than Ⅳ stage patients (109.48±29.65)pg/ml(P=0.0392). There were25cases in effective group (CR+PR). Serum VEGF level before chemotherapy was (673.77±142.25)pg/ml and after chemotherapy(571.23±132.52)pg/ml and decreased significantly and there was significant difference (p=0.0112). There were20cases in inefficacy group (NC+PD). Serum VEGF level before chemotherapy was(662.87±152.63)pg/ml, after chemotherapy(676.51±134.48) pg/ml and there was no significant difference before and after chemotherapy (p=0.7211). Serum ES level of effective group (CR+PR) before chemotherapy was (113.11±28.25) ng/ml, after chemotherapy(137.31±36.25)ng/ml and significantly increased and there was significant difference (p=0.0114); serum ES level of inefficacy group (NC+PD) before chemotherapy was(110.45+43.56)ng/ml, after chemotherapy (108.87±41.36) ng/ml and there was no significant difference (p>0.05). This study also analyzed the relation of serum VEGF and serum ES and survival and the result shows that serum VEGF level of24patients were higher than average (668.93pg/ml), median survival time9.2months and serum VEGF level of16patients were lower than average, median survival time13.5months, log-rank testing:4.477and the difference has statistical significance (p=0.034); serum ES level of23patients were higher than average (111.95ng/ml), median survival time14.2months and serum ES level of17 patients were lower than average, median survival time10.5months, log-rank testing:7.473and the difference has statistical significance (p=0.006).The result was analyzed by Peason and shows:r=0.123, p=0.421(bilateral) and serum VEGF level and serum ES level of advanced NSCLC patients before chemotherapy has no relation.Conclusion1. Serum VEGF and serum ES in advanced NSCLC patients are highly expressed and suggests relation with angiogenesis of lung cancer.2. Serum VEGF and serum ES have relation with tumor staging and it could reflect malignant invasion ability of non-small cell lung cancer.3. Serum VEGF level of effective group after chemotherapy significantly decreased and serum ES level significantly increased and there was no significant difference and it is valuable for evaluting chemotherapy curative effects.4. The expression of serum VEGF and serum ES has relation with prognosis and serum VEGF expression is higher and the survival time is shorter; serum ES expression is higher and the survival time is longer. This shows that serum VEGF and serum ES are valuable indexes to evaluate prognosis.