CAJ | 학술논문

目的探讨血清血管内皮生长因子C(VEGF-C)含量对进展期胰腺癌患者预后判断的价值.方法选择2006年8月至2008年2月问收治的35例进展期胰腺癌患者,采用ELISA法检测患者血清VEGF-C、CA19-9含量,行KPS评分,应用Kaplan-Meier法计算生存率.log-rank法检验不同变量间生存率的差异,Cox回归模型进行单因素和多因素分析.结果 35例胰腺癌患者血清VEGF-C含量平均为(1309±542)pg/ml,显著高于健康对照者的(278±115)pg/ml(P<0.01).应用Cox风险模型对影响进展期胰腺癌患者预后因素行单因素分析,KPS评分、血清CA19-9及VEGF-C均为独立影响因素(x2=7.208、6.908、3.867,P=0.007、0.009、0.049);行多因素分析,血清VEGF-C和KPS评分为独立影响因素(x2=4.873,P=0.027;x2=5.274,P=0.022).以血清VEGF-C含量1280 pg/ml为分界点,≤1280 pg/ml患者的中位生存时间为10.0个月,平均生存时间为11.3个月,1年累积生存率为50.0%;而>1280 pg/ml患者分别为6.0、6.3个月和5.9%.两组间差异有统计学意义(x2=9.400,P=0.002).以KPS评分70为界,<70患者中位生存时间为6.0个月,平均生存时间为6.6个月,1年累积生存平均为21.4%;而≥70分者分别为9.0、10.1个月和33.3%,两组间差异有统计学意义(x2=4.040,P=0.044).血清CA19-9值≤200 U/ml与>200 U/ml的两组患者的平均生存时间(10.0个月比7.8个月)、1年累积生存率(37.5%比21.1%)差异均无统计学意义(x2=1.910,P=0.167).结论血清VEGF-C含量可作为判断进展期胰腺癌患者预后的独立影响因素.
목적 탐토혈청혈관내피생장인자C(VEGF-C)함량대진전기이선암환자예후판단적개치.방법 선택2006년8월지2008년2월문수치적35례진전기이선암환자,채용ELISA법검측환자혈청VEGF-C、CA19-9함량,행KPS평분,응용Kaplan-Meier법계산생존솔.log-rank법검험불동변량간생존솔적차이,Cox회귀모형진행단인소화다인소분석.결과 35례이선암환자혈청VEGF-C함량평균위(1309±542)pg/ml,현저고우건강대조자적(278±115)pg/ml(P<0.01).응용Cox풍험모형대영향진전기이선암환자예후인소행단인소분석,KPS평분、혈청CA19-9급VEGF-C균위독립영향인소(x2=7.208、6.908、3.867,P=0.007、0.009、0.049);행다인소분석,혈청VEGF-C화KPS평분위독립영향인소(x2=4.873,P=0.027;x2=5.274,P=0.022).이혈청VEGF-C함량1280 pg/ml위분계점,≤1280 pg/ml환자적중위생존시간위10.0개월,평균생존시간위11.3개월,1년루적생존솔위50.0%;이>1280 pg/ml환자분별위6.0、6.3개월화5.9%.량조간차이유통계학의의(x2=9.400,P=0.002).이KPS평분70위계,<70환자중위생존시간위6.0개월,평균생존시간위6.6개월,1년루적생존평균위21.4%;이≥70분자분별위9.0、10.1개월화33.3%,량조간차이유통계학의의(x2=4.040,P=0.044).혈청CA19-9치≤200 U/ml여>200 U/ml적량조환자적평균생존시간(10.0개월비7.8개월)、1년루적생존솔(37.5%비21.1%)차이균무통계학의의(x2=1.910,P=0.167).결론 혈청VEGF-C함량가작위판단진전기이선암환자예후적독립영향인소.
Objective To investigate the value of serum concentration of VEGF-C in the prognosis of advanced pancreatic cancer. Methods Thirty-five patients with advanced pancreatic cancer were selected from Aug. 2006 to Feb. 2008, ELISA method was used to detect the serum level of VEGF-C, CA19-9 and KPS score was calculated, and survival was analyzed by Kaplan Meier method. The survival difference was calculated by log rank. Cox regression model was used to perform univariate and multivariate analysis. Results The mean serum concentration of VEGF-C was ( 1309 ± 542 ) pg/ml in patients with advanced pancreatic cancer, which were significantly higher than that those in normal control [ (278 ±115) pg/ml, P <0.01 ]. In Cox regression, KPS score, serum CA19-9 and VEGF-C were independent factors (x2 =7.208, 6.908, 3.867, P = 0.007, 0.009, 0.049). In multivariate analysis, serum VEGF-C and KPS score were independent factors (x2 =4.873, P=0.027, x2 =5.274, P =0.022). Using serum concentration of VEGF-C at 1280 pg/ml as the cut-off point, the mean survival of patients with VEGF-C ≤1280 pg/ml was 10.0 months, and the median survival was 11.3 months, 1 year cumulative survival was 50.0% ; while they were 6.0 months, 6.3 months and 5.9% in patients with VEGF-C > 1280 pg/ml, and the difference was statistically significant (x2 = 9.400, P= 0.002). Using KPS score 70 as the cut-off point, the mean survival of patients with KPS <70was 6.0 months, and the median survival was 6.6 months, 1 year cumulative survival was 21.4% ; while they were 9.0 months, 10.1 months, 33.3% in patients with KPS score ≥70,and the difference was statistically significant (x2 =4.040, P =0.044). The difference of the median survival, 1 year cumulative survival in patients with CA19-9 ≤200 U/ml or >200 U/ml was not statistically significant (10.0 months vs. 7.8 months, 37.5% vs. 21.1% ; x2 =1910, P=0. 167). Conclusions Serum concentration of VEGF-C can used as an independent factor for predication of prognosis of patients with advanced pancreatic cancer.