The Study Of The Relation Of Circulating Endothelial Cells Content,the Level Of Vascular Endothelial Growth Factor And The Efficacy Of Chemotherapy With Endostar In Advanced NSCLC

ObjectiveTo compare the clinical effects of NSCLC by the treatment of endostar plus NP chemotherapy or NP regimen,and the diversity of the level of VEGF,and CECs.MethodsPatients who were enrolled were divided into NP chemotherapy group and endostar plus NP chemotherapy group,patients of NP chemotherapy group were accepted NP regimen including vinorelbine 25mg/m² ivdrip d_1,8; cisplatin 35mg/m² ivdrip d_1,2 with a 21-day cycle, patients in endostar plus NP chemotherapy group were accepted NP regimen including vinorelbine 25mg/m² ivdrip d_1,8; cisplatin 35mg/m² ivdrip d_1,2 ,endostar 7.5mg/m² ivdrip d_1-14 with a 21-day cycle. Then the blood was drew befor the treatment and after the 2ed cycle,to detect CEA level by the dependability analysis, VEGF level was detected by Elisa detect, and CEC counts was detected using fluorescent antibody labeling flow cytometry.Results1. 22 persons enrolled in the NP group, and 2 of them ware excluded because of the using G-CSF,then 20 were included finally,21 were enrolled in the endostar plus NP group,and 2 of them ware excluded because of the using G-CSF,1 discharged after the first cycle, finally only 18 were included. 2.There were no CR patients in both groups,in NP group, PR 5 (25.0%), SD 6 (30%), PD 9 (45%) with RR 5(25.0%) and clinical benefit 55%,in endostar plus NP group, PR 5 (27.8%), SD 10 (55.5%), PD 9 (16.7%) with RR 5(27.8%) and clinical benefit 83.3%, the different in the clinical benefit between NP and endostar plus NP group was statistically significance(p<0.05).3.The difference in VEGF and CECs in NP and endostar plus NP group has no statistically significance(p>0.05)4.The influence of clinical factors to VEGF level and CEC counts: we analyzed clinical factors including sex, age, ECOG, histology, encroachment. Among them, only the influence of encroachment had statistical significance (p<0.05).5.VEGF level and CEC counts comparison between clinical response group and clinical benefit group:the difference of VEGF level and CECs counts in the clinical response group between the NP and endostar plus NP group had no statistical significance(p>0.05),but the difference of VEGF level and CECs counts in the clinical benefit group between the NP and endostar plus NP group was statistically significant(p<0.05).6.Correlation between CEA level, VEGF and CEC counts:There were positive correlation between CEA level and VEGF level before and after the first cycle (P=0.847;0.632). There were positive correlation between CEA level and CEC counts before treatment, and no correlation between CEA level and CEC counts after the 2^nd cycle of treatment.Conclusion1.Endostar enhances the clinical benefit rate in the treatment ofâ…¢B/â…£stage NSCLC.2.Endostar plus NP could decrease the level of CEA before and after the treatment.3.Endostar plus NP can not affect the level of VEGF and CECs counts in NP and endostar plus NP group.4.Sex, age, ECOG, histology, do not affect the level of VEGF and CECs counts in NP and endostar plus NP group. 5.Only the encroachment had the influence on the level of VEGF and CECs counts, the level of VEGF and CECs counts befor treatment in distent metastasis group was higher than the local advanced stage group, so did the decrease of the level of VEGF and CECs counts after treatment.6.Endostar plus NP could decrease the level of VEGF and CECs counts in clinical benefit patients.7.No bone marrow depression was incrased in Endoster puls NP group.8.There is positive correlation between VEGF level (befor / afrer chemotherapy) and CEA befor chemotherapy, so did the CECs.9.There is positive correlation between VEGF level (befor / afrer chemotherapy) and CECs befor chemotherapy.