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目的分析晚期非小细胞肺癌(NSCLC)患者治疗前后外周血中循环血管内皮细胞(CEC)的变化,探讨CEC在NSCLC中的应用价值。方法采用NP方案联合内皮抑素(治疗组)及单用NP方案(对照组)治疗晚期NSCLC 67例,流式细胞法检测治疗前后外周血CEC数量及细胞角蛋白(CK)水平。结果治疗组临床有效率为44．4％,对照组为27．3％(P=0．176);治疗组临床受益率为80．0％,对照组为50．0％(P=0．012)。治疗组肿瘤进展时间(TTP)为146．7 d,对照组为91．1 d (P=0．061)。当TTP的cut-off值>170时,两组TTP比较,差异有统计学意义(cut-off值=170,P= 0．034;cut-off值=180,P=0．009)。治疗组CEC平均下降(0．29±0．47)％,对照组平均下降(0．01±0．43)％(P=0．033)。全部患者治疗前CEC与CK水平呈正相关(r=0．381,P=0．013),治疗后亦呈正相关(r=0．450,P=0．004)。结论化疗联合血管靶向治疗晚期NSCLC优于单用化疗,CEC是一个较好的预测疗效的指标。
Objective To analyze the changes of circulating vascular endothelial cells (CECs) in peripheral blood of patients with advanced non-small cell lung cancer (NSCLC) before and after treatment, and to explore the value of CEC in NSCLC. Methods Sixty-seven patients with advanced non-small cell lung cancer (NSCLC) were treated with NP regimen combined with endostatin (treatment group) and single NP regimen (control group). The levels of peripheral blood CEC and cytokeratin (CK) were measured by flow cytometry. Results The clinical effective rate was 44.4% in the treatment group and 27.3% in the control group (P = 0.176). The clinical benefit rate was 80.0% in the treatment group and 50.0% in the control group (P = 0. 012). TTP was 146.7 days in the treatment group and 91.1 days in the control group (P = 0.061). When the cut-off value of TTP was> 170, the difference between the two groups was statistically significant (cut-off value = 170, P = 0.034; cut-off value = 180, P = 0.009). CEC decreased in the treatment group (0.29 ± 0.47)% on average, and decreased by (0.01 ± 0.43)% in the control group (P = 0.033). All patients had a positive correlation between CEC and CK levels before treatment (r = 0.381, P = 0.013). After treatment, there was a positive correlation between CEC and CK (r = 0.450, P = 0.004). Conclusions Chemotherapy combined with vascular targeting is superior to chemotherapy alone in advanced NSCLC. CEC is a good predictor of efficacy.