| Objective: To analyze the relationship of serum vascular endothelialgrowth factor/platelet count (VEGF/PLT) as well as osteopontin (OPN) andclinical factors, pathological factors and imaging findings by determining thetwo variables in experimental group with locally advanced non-small cell lungcancer (NSCLC) and control group with healthy people; to observe the trendsof these two variables after concurrent chemoradiotherapy and theirrelationship with the clinical efficacy and analyze their correlation, and toevaluate their application value in the surveillance of locally advancedNSCLC disease.Methods: Fifty-six cases of locally advanced non-small cell lung cancertreated in First Hospital of Qinhuangdao City from December2009toFebruary2012were randomly screened as experimental group, while fortycases of healthy adults exclusive of related diseases from physicalexamination center served as control group.1Fasting venous blood samples were collected from patients in bothexperimental and control groups. Enzyme-linked immunosorbent assay(ELISA) was employed to determine the expression of serum VEGF/PLT andOPN. The cases in experimental group then underwent three-dimensionalconformal radiotherapy (3D-CRT). In the late period, the field was reduced toincrease irradiation on residual target volume to DT6270Gy and25mg/m2cisplatin was used simultaneously, which then lasted for six weeks.Expressions of serum VEGF/PLT and OPN were determined again in3weeksafter the treatment and patients underwent chest CT scan; according to the CTfindings the group was divided into the valid group (CR+PR) and the invalid group (SD+PD) respectively.2The differences in serum VEGF/PLT and OPN were analyzed in bothgroups; the relationship between these two variables and clinical factors,pathological factors and imaging findings before treatment in experimentalgroup was investigated, to observe the change in expression of serumVEGF/PLT and the OPN before and after the concurrent chemoradiotherapyand their correlation, and to analyze the multiple factors that had an impact ona short-term effect.3Statistical analysis: Statistical analysis was performed by usingSPSS13.0software package. T test was used in comparison between groups,correlation between VEGF/PLT and the OPN underwent Pearson correlationanalysis and Logistic regression analysis was used in multivariate analysis aswell. P <0.05was considered statistically significant.Results:1Before NSCLC concurrent chemoradiotherapy, serum VEGF/PLT, OPNexpressions were (0.83±0.08)10-6pg and (31.24±5.61) ng/ml, which werehigher than those in control group,(0.43±0.10)10-6pg and (22.99±6.09) ng/ml respectively, and the difference was statistically significant (t=21.51,5.88,P <0.05).2In groups with different gender, age and smoking status, the expressiondifferences of VEGF/PLT and OPN levels in serum of NSCLC patients werenot statistically significant (t=0.10,0.44;0.32,0.37;0.16,0.52, P>0.05); theexpressions of VEGF/PLT and OPN in the group with lymph node metastasis(N1-N3) were (0.84±0.08)10-6pg and32.07±7.18ng/ml, which wassignificantly higher than those in the group without lymph node metastasis(N0),(0.77±0.07)10-6pg and (25.54±4.81) ng/ml, and the difference wasstatistically significant (t=2.05,2.33, P <0.05); expression of VEGF/PLT andOPN in Hb≤100g/L group were (0.89±0.15)10-6pg and (38.85±9.06)ng/ml respectively, which were significantly higher than those in Hb>100g/L group,(0.81±0.05)10-6pg and (29.39±5.53)ng/ml, and thedifference was statistically significant (t=2.85,4.53, P <0.05); expressions of VEGF/PLT and OPN in the group with KPS score≤90were (0.87±0.13)10-6pg and (35.75±9.02)ng/ml respectively, which were significantly higherthan those in the group with KPS score>90,(0.81±0.05)10-6pg and (29.45±5.54)ng/ml, and the difference was statistically significant (t=2.05,3.18, P<0.05); expressions of VEGF/PLT and OPN in the group with the time ofradiotherapy≤46-day were (0.82±0.06)10-6pg and (29.04±5.42)ng/ml,which were significantly lower than those in the group with the time ofradiotherapy>46days,(0.87±0.13)10-6pg and (37.29±8.23)ng/ml, and thedifference was statistically significant (t=2.05,4.36, P <0.05).3The expression of serum VEGF/PLT of NSCLC patients in squamouscell carcinoma group was (0.85±0.09)10-6pg, which was significantly higherthan the level of (0.80±0.05)10-6pg in the group with adenocarcinoma; theexpression of OPN in the group with squamous cell carcinoma was (33.22±7.33)ng/ml, which was significantly higher than the level of(27.41±5.33)ng/ml in the group with carcinoma, and the difference was statisticallysignificant (t=2.16,3.06, P <0.05); expressions of VEGF/PLT and OPN in thegroup with pathologic grade, the well-differentiated and the moderatelydifferentiated one,were (0.81±0.05)10-6pg and28.41±4.85ng/ml, whichwere significantly lower than those in the poorly differentiated group,(0.85±0.10)10-6pg and (33.71±8.08)ng/ml, and the difference was statisticallysignificant (t=2.14,2.92, P <0.05). expressions of VEGF/PLT and OPN in thegroup with tumor diameter≤3cm were (0.78±0.07)10-6pg and (25.33±3.37)ng/ml respectively, which were significantly lower than those in thegroup with the tumor diameter>3cm,(0.84±0.09)10-6pg and(32.86±7.17)ng/ml, and the difference was statistically significant (t=2.10,3.52, P <0.05).4Expression of serum VEGF/PLT and OPN in groups with the differentlocations of the tumor had not statistically significant difference (t=1.45,0.51,P>0.05); expression of VEGF/PLT and OPN in the group with spiculationwere (0.84±0.09)10-6pg and (32.34±7.24)ng/ml respectively, which weresignificantly higher than the group without spiculation,(0.78±0.06)10-6pgand (26.32±4.79)ng/ml, and the difference was statistically significant (t= 2.20,2.54, P <0.05); VEGF/PLT and OPN expression in the group with thelobulation were (0.85±0.09)10-6pg and (32.62±7.45)ng/ml respectively,which were significantly higher than those in the group with no lobulation,(0.79±0.04)10-6pg, and (27.13±4.64)ng/ml, and the difference wasstatistically significant (t=2.06,2.58, P <0.05).5Prior to concurrent chemoradiotherapy, expressions of serumVEGF/PLT and OPN in the valid group (CR+PR) were (0.82±0.09)10-6pgand (31.93±7.61)ng/ml, and after treatment both expressions decreasedsignificantly respectively,(0.43±0.07)10-6pg and (25.55±4.14)ng/ml, andthe differences were statistically significant (t=25.37,4.61, P <0.05); in theprogression group (SD+PD), the expressions of both were significantlyincreased, which showed statistically significant difference (t=4.52,2.91, P<0.05).6Before and after concurrent chemoradiotherapy, expressions of serumVEGF/PLT and OPN of the patients with locally advanced NSCLC showed apositive correlation (r=0.35,0.37, P <0.05).7Multivariate analysis showed that: tumor diameter as well as bothserum VEGF/PLT and OPN after treatment were independent influentialfactors in short-term efficacy of locally advanced NSCLC (OR=2.59,4.61,8.46, P <0.05).Conclusions:1Serum VEGF/PLT and OPN in NSCLC were highly expressed;VEGF/PLT and the OPN were highly expressed in lung squamous cellcarcinoma, and these two might have a certain correlation with pathologicalclassification of NSCLC, which had diagnostic value.2The levels of serum VEGF/PLT and OPN were closely related to lymphnode metastasis status, hemoglobin and KPS score; presence of regionallymph node metastasis led to higher expressions in both variables; the lowerthe KPS score was, the higher the expressions would be; the lower the contentof hemoglobin was, the higher levels of serum VEGF/PLT would be and thelower levels of OPN; and levels of these two variables were not correlated with gender, age and smoking status.3Serum VEGF/PLT and OPN levels were closely related to pathologicalgrade and tumor diameter; the larger the tumor diameter was and the lower thedegree of differentiation would be, the higher expression they would have inserum.4Serum VEGF/PLT and OPN had high expression in CT signs withspiculation and lobulation, indicating a higher degree of malignancy, whichwas evidence of invasion and metastasis.5Before and after concurrent chemoradiotherapy, serum VEGF/PLT andOPN level changes were associated with clinical efficacy; better clinicaloutcome led to significant decrease; both were significant in terms of efficacyevaluation.6Before and after treatment, serum VEGF/PLT and the OPN levels inlocally advanced NSCLC patients were positively correlated and the combineddetection has an important value in lung cancer diagnosis and treatmentevaluation.7Tumor diameters, serum VEGF/PLT after treatment and OPN aftertreatment were independent factors for locally advanced NSCLC patients inshort-term effect. The smaller the tumor diameter was, the shorter the totaltreatment time would be. |
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