Change And Significance Of VEGF And BFGF Level In Platelet And Plasma Before And After Surgery And Chemotherapy Of Breast Cancer Patients

Objective: Investigate change and significance of VEGF and b FGF level in platelet and plasma before and after surgery and chemotherapy of breast cancer patients, and provide a reference for evaluation of therapeutic effect of breast cancer and for study of recurrence monitoring system.Method: In the study, double-antibody sandwich ELISA(enzyme linked immunosorbent assay, ELISA method) was adopted to test platelet content and plasma VEGF & b FGF contents in 30 cases of breast cancer patients, and relative value of platelet VEGF was calculated according to content of VEGF / total protein concentration; similarly, relative value of platelet b FGF was calculated. Comparative study was done for relative values of platelet VEGF & b FGF before and after operation of breast cancer patients as well as before, during and after chemotherapy, and was compared with control group with benign tumor to explore their correlation with therapeutic effect. Result:1. Comparison of platelet VEGF and b FGF levels of breast cancer patients before, during and after chemotherapyThe median of platelet VEGF relative values of breast cancer patients before, during and after chemotherapy are: 1698.64(1312.95-3119.16)pg/mg, 1240.84(916.33-1527.43)pg/mg and 789.99(473.23-1117.58)pg/mg respectively, and the median of platelet b FGF relative values are: 123.89(90.67-160.53)pg/mg, 87.80(63.29-134.57)pg/mg and 62.70(27.49-83.77)pg/mg respectively, which shows that VEGF and b FGF levels in platelet gradually decline. The difference is statistically significant(P<0.001), and it is significantly higher than optimum control group(the median of platelet VEGF in patients with benign tumor is 358.9408(interquartile range is 209.52-528.65)pg/mg, and the median of platelet b FGF is 47.35(interquartile range is 29.30-70.03)pg/mg), and the difference is statistically significant(P<0.05);2. Comparison of plasma VEGF and b FGF levels of breast cancer patients before, during and after chemotherapyThe median of plasma VEGF relative values of breast cancer patients before, during and after chemotherapy are: 36.69(23.92-43.11)pg/mg, 28.57(19-37.93)pg/mg and 16.45(11.56-23.89)pg/mg respectively, and the median of plasma b FGF relative values are: 6.14(4.38-7.50)pg/mg, 6.47(3.38-7.11)pg/mg and 2.64(1.26-4.44)pg/mg respectively, which shows that VEGF and b FGF levels in plasma gradually decline. The difference is statistically significant(P<0.001), and it is higher than optimum control group(the median of plasma VEGF in patients with benign tumor is 9.61(6.91-14.62)pg/mg, and the median of plasma b FGF is 1.74(1.48-2.40)pg/mg), and the difference is statistically significant(P<0.05).3. Comparison of variation trend of platelet and plasma VEGF & b FGF levelsThe median of platelet VEGF of breast cancer patients before and after operation are 1455.28(1354.96-1842.88)pg/mg and 3213.29(1479.67-4281.89) pg/mg respectively. The value after operation is higher than before operation, compare the two values that P<0.05, and the difference is statistically significant; the median of plasma VEGF before and after operation are 28.52(25.16-44.54) pg/mg and 36.43(20.73-61.87) pg/mg respectively; the median of platelet b FGF before and after operation are 101.67(58.79-123.12) pg/mg and 134.82(94.18-164.04) pg/mg respectively; the median of plasma b FGF before and after operation are 5.01(1.55-6.47) pg/mg and 4.29(1.55-6.41) pg/mg respectively. Comparing the difference before and after operation, the difference isn't statistically significant(P>0.05);There is difference for pair wise comparison of VEGF relative value in platelet and plasma before, during and after chemotherapy, and the difference is statistically significant(P<0.05). For pair wise comparison of b FGF in platelet and plasma before, during and after chemotherapy, the difference is statistically significant for comparison before and after chemotherapy as well as during and after chemotherapy(P<0.05), while the difference is not statistically significant for comparison before and during chemotherapy(P>0.05).4. Comparison of platelet VEGF and b FGF levels of breast cancer patients after NAC6 in 15 cases of breast cancer patients achieve p CR after NAC. The median of platelet VEGF in p CR group before, after chemotherapy and difference between before and after chemotherapy are 1583.95(1501.23-1730.7) pg/mg, 239.41(233.27-245.97) pg/mg and 1344.55(1257.89-1476.16) pg/mg respectively; that of non-p CR group are 1389.87(1237.04-1822.86) pg/mg, 848.34(693.28-989.96) pg/mg and 728.43(297.35-826.24) pg/mg. The difference is not statistically significant before chemotherapy(P>0.05), the value of p CR group is lower than non-p CR group after chemotherapy, and the difference of p CR group before and after chemotherapy is higher than non-p CR group. The difference is statistically significant(P<0.05).The median of platelet b FGF in p CR group before & after chemotherapy and difference between before and after chemotherapy are 142.29(126.46-172.98)pg/mg, 27.50(16.15-32.16)pg/mg and 117.07(96.30-144.60)pg/mg; the non-p CR group are 116.34(88.75-124.66)pg/mg, 69.76(64.55-80.50)pg/mg and 26.08(23.54-62.30)pg/mg respectively. The difference of p CR and non-p CR before chemotherapy is not statistically significant(P>0.05), the value of p CR group is lower than non-p CR group after chemotherapy, and the difference of p CR before and after chemotherapy is higher than non-p CR group. The difference is statistically significant(P<0.05).The median of plasma VEGF and b FGF in p CR group before & after chemotherapy and the difference between before and after chemotherapy are: 38.88(37.00-43.89) pg/mg, 14.78(8.78-26.11) pg/mg and 20.76(10.07- 34.97) pg/mg for VEGF, and 7.65(7.09-9.40) pg/mg, 2.64(2.18-3.89) pg/mg and 4.68(3.05-6.75) pg/mg for b FGF; VEGF in non-p CR group are 34.89(25.00-38.64) pg/mg, 15.74(12.05-16.02) pg/mg and 20.53(9.02-23.42) pg/mg, and b FGF is 6.52(4.79-7.61) pg/mg, 3.26(2.21-5.89) pg/mg and 3.25(2.44-3.54) pg/mg. The two groups are compared before and after chemotherapy as well as difference between before and after chemotherapy respectively, and the difference was not statistically significant(P>0.05). Conclusion:1. VEGF and b FGF levels in platelets are significantly higher than that in plasma, it is more concentrated, which is more conducive to monitor condition changes of tumor patients before and after treatment.2. Both VEGF and b FGF levels in platelet and plasma have some value for monitoring of chemo response. But the difference of platelet VEGF and b FGF in p CR group is significantly greater than non-p CR group, while the two groups in plasma are not statistically significant. Therefore, measuring relative value of VEGF and b FGF in platelet has greater significance in terms of monitoring and evaluation of chemotherapy efficacy than that in plasma.