Shen Hong, Feng Ganzhu, Cui Jin, Du Qiang, Qin Yong, Cai Jiankang, Shen Li, Zhu Yina
Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing - China.
Tumori. 2015 Jul-Aug;101(4):404-11. doi: 10.5301/tj.5000320. Epub 2015 May 13.
Hypoxia inducible factor 1α (HIF-1α) and vascular endothelial growth factor (VEGF) have been deemed as key in angiogenesis of lung cancer. The aim of this study was to investigate diagnostic and prognostic values of HIF-1α and VEGF in patients with lung cancer.
From May 1, 2011, to April 20, 2014, blood samples and/or pleural effusions were collected from 100 patients with lung cancer, 18 patients with tuberculosis, 47 patients with community-acquired pneumonia, and 29 healthy controls. The pretreatment levels of HIF-1α and VEGF were measured by enzyme-linked immunoassays. Patients with lung cancer were followed up during the period of this study and survival times were recorded for analysis.
We detected that the levels of serum and pleural HIF-1α in lung cancer were significantly higher than those in the tuberculosis population, and that the VEGF expressions were not significantly different between malignancy and benign diseases. An area under the curve of pleural HIF-1α (0.877 ± 0.053) showed a high ability to differentiate lung cancer from benign diseases. The significant negative predictors of survival in the univariate analysis were performance status (gt;1), no anticancer therapy, low serum albumin, advanced stage, and serum high level of VEGF (gt;324.17 pg/mL), while in the multivariate Cox regression analysis, only the pretreatment serum level of VEGF, stage, and anticancer therapy were identified as independent prognostic factors.
The overexpression of HIF-1α especially in pleural effusion may be an angiogenic factor for distinguishing malignancy from tuberculosis, and the pretreatment level of serum VEGF may be an independent predictor of survival.
缺氧诱导因子1α（HIF-1α）和血管内皮生长因子（VEGF）被认为是肺癌血管生成的关键因素。本研究旨在探讨HIF-1α和VEGF在肺癌患者中的诊断及预后价值。
2011年5月1日至2014年4月20日期间，收集了100例肺癌患者、18例肺结核患者、47例社区获得性肺炎患者及29例健康对照者的血液样本和/或胸腔积液。采用酶联免疫吸附测定法检测HIF-1α和VEGF的治疗前水平。在本研究期间对肺癌患者进行随访，并记录生存时间以进行分析。
我们检测到肺癌患者血清和胸腔HIF-1α水平显著高于肺结核患者，而恶性肿瘤与良性疾病之间VEGF表达无显著差异。胸腔HIF-1α的曲线下面积（0.877±0.053）显示出较高的区分肺癌与良性疾病的能力。单因素分析中生存的显著负性预测因素为体能状态（＞1）、未进行抗癌治疗、血清白蛋白水平低、晚期以及血清VEGF高水平（＞324.17 pg/mL），而多因素Cox回归分析中，仅治疗前血清VEGF水平、分期及抗癌治疗被确定为独立预后因素。
HIF-1α的过表达尤其是在胸腔积液中可能是区分恶性肿瘤与肺结核的血管生成因子，血清VEGF的治疗前水平可能是生存的独立预测因素。
