Variations Of Plasma Concentration Of BDNF、VEGF、IL-17A、IL-17F And Its Clinical Significance Of Patients In Perioperative Period

Objective:To explore the variation of perioperative plasma concentration of BDNF and its clinical significance in patients undergoing perioperative period.To dectect the levels of brain derived neurotrophic factor(BDNF),vascular endothelial growth factor(VEGF),interleukin-17A(IL-17A),interleukin-17F(IL-17F)by enzyme-links immunosorbent assays(ELISA)in patients with oral squamous cell carcinoma,oral precancerous lesions and healthy people.To study the correlation of the four and investigate the relevance of it to the clinicopathologic characteristics of carcinoma patients.Materials and Methods:Totally 118 patients were enrolled in this study(63 boys and 55 girls,mean age of 46.71±8.53).BDNF plasma concentrations were determined in blood samples using enzyme-links immunosorbent assays at five time points:T1(baseline),T2(after intubation and before the surgery was started),T3(end of surgery),T4(20minutes after extubation),T5(24 hours after the surgery).Hamilton anxiety scale(HAMA)was used to determine their status of anxiety.The results were statistically analyzed by GraphPad Prism5.0 software.Mann-Whitney U test was used to compare changes of BDNF plasma concentrations.The relationship was analyzed by spearman rank correlation analyze.p<0.05 was considered statistically significant.We selected patients compliance with our requirement,divided their into groups of Oral squamous cell carcinoma(OSCC),Oral precancerous lesions(OPL).We selected normal control group(NC)in society.All the subject investigated need their peripheral venous blood samples,detected the concentration of BDNF,VEGF,IL-17A,IL-17F by enzyme-links immunosorbent assays(ELISA).The results were statistically analyzed by GraphPad Prism5.0 software.Kruskal-Wallis statistic was used in the comparison of BDNF,VEGF,IL-17A,IL-17F in the three groups.Mann-Whitney U test was used to compare the two groups.The relationship was analyzed by spearman rank correlation analyze.p<0.05 was considered statistically significant.Results:1.Before and after surgery,the concentrations of plasma BDNF and patients basic characteristic have no statistically significant correlation(p>0.05).2.The concentrations of plasma BDNF in patients undergoing perioperative period:T1(626.5 ± 283.7pg/ml),T2(315.5 ± 205.2pg/ml),T3(710.7 ±478.5pg/ml),T4(663.8±533.4pg/ml),T5(249.2 ± 110.1pg/ml).T1 as baseline,concentrations of plasma BDNF at T2 were significantly reduced(p=0.0017).Concentrations of plasma BDNF at T3 and T4 have no statistically significant(p=0.616).BDNF plasma concentrations at T3 were higher than T2(p<0.01).At T5,BDNF plasma concentrations decreased below baseline,have statistically significant(p<0.05).3.There was a statistically significant positive correlation between the duration of surgery and BDNF values at end of surgery(rs=0.2289,p=0.0139),at T3,the variability in BDNF plasma concentrations ranged from 55pg/ml to 1920pg/ml.There was no correction between the BDNF plasma concentrations of T5 and the duration of surgery(rs=0.1539,p=0.1006).4.Combine with Hamilton anxiety scale(HAMA),the degree of anxiety was negatively related to BDNF plasma concentrations,and have statistically significant(rs=-0.308,p=0.0008).After operation,the degree of anxiety was significantly increase(p=0.011).5.The concentrations of plasma BDNF in groups of Oral squamous cell carcinoma group(OSCC),Oral precancerous lesions group(OPL),normal control group(NC):(618± 447.7pg/ml)(555.6±454.1pg/ml)(547.5±434.9pg/ml).The concentrations of plasma BDNF of the three groups have no statistically significant(p=0.6227).The concentrations of plasma BDNF and VEGF of OSCC groups have no statistically correlation with each other(rs=-0.1982,p=0.1508).The concentrations of plasma BDNF have no statistically with patients clinicopathological characteristics.6.The plasma VEGF,IL-17A,IL-17F level of OSCC group were(172.4 ±76.25pg/ml)(33.19 ± 12.6pg/ml)(115.3 ± 51.52pg/ml);The plasma VEGF,IL-17A,IL-17F level of OPL group were(130.3 ±45.24pg/ml)(24.67 ±11.62pg/ml)(152.9 ± 70.08pg/ml);The plasma VEGF,IL-17A,IL-17F level of NC group were(103.5±36.17pg/ml)(18.74±6.337pg/ml)(230.9 ± 161.8pg/ml);In this study showed that plasma concentration of VEGF and IL-17A were remarkably down-regulated from OSCC group,OPL group to normal control group.Conversely,the normal control group had a highest level of IL-17F in the whole groups,and there was a positive correlation between VEGF and IL-17A(rs=0.3062,p=0.0243),a negative correlation between VEGF and IL-17F(rs=-0.27,p=0.0484),no correlation between IL-17F and IL-17A(rs=0.0456,p=0.7435).7.The concentration of VEGF were significantly corrected with tumor size(p=0.0181),tumor-node-metastasis(TNM)stage(p=0.0169),lymph node metastasis(P=0.0249)and differentiation(p=0.008).The concentration of IL-17A were significantly corrected with somking habit(p=0.014),TNM stage(p=0.0343),lymph node metastasis(p=0.0403).The concentration of IL-17F were significantly corrected with drinking(p=0.0469)and somking habit(p=0.0272),tumor size(p=0.0124),TNM stage(p=0.0334),lymph node metastasis(p=0.0465).8.Using ROC curve illustrated the diagnostic value of VEGF、IL-17A 与IL-17F.Results that the ratio of IL-17F/VEGF was the best diagnostic marker of OSCC than other markers.Conclusion:1.These data suggest that patients in perioperative period,BDNF plasma concentrations show a specific pattern that is correlation with the duration of surgery,anesthetic.Anesthesia might be aggravate the anxiety of patients in perioperative period,the mechanism might be related to the decrease of the concentrations of plasma BDNF.2.There have no statistically correlation of the plasma BDNF and VEGF concentrations,further more there have nothing to do with the progression of OSCC.3.The concentrations of plasma VEGF,IL-17A,IL-17F are linked to progression of OSCC,and combined as a good diagnostic marker.