Yao Jing-Hao, Shao Yu, Wang Jun-Jun, Li Yu-Long, Yang Han-Qi, Liu Jing, Yang Yan
Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
J Cancer. 2021 Jan 1;12(5):1356-1364. doi: 10.7150/jca.51972. eCollection 2021.
To evaluate diagnostic and predictive values of the serum vascular endothelial growth factor-A (VEGF-A) level and systemic immune-inflammation index (SII) in small cell lung cancer (SCLC) patients. From January 2018 to April 2020, we prospectively enrolled 59 untreated SCLC patients in the study group and 50 non-neoplastic patients in the control group. Blood samples were collected at baseline, after the first two cycles of chemotherapy and at progression in the study group and at entry in the control group. Serum VEGF-A was measured by chemiluminescence, SII was calculated based on complete blood count results, and the relationship between the VEGF-A/SII and clinicopathological characteristics, chemotherapeutic efficacy and progression-free survival (PFS) of SCLC patients was analyzed. Baseline serum VEGF-A was significantly higher in SCLC patients than in non-neoplastic patients (0.001), while baseline SII was not (0.114). There was no correlation between baseline VEGF-A and SII in SCLC patients (0.123); however, there was a significant correlation between baseline VEGF-A and disease stage and central nervous system (CNS) metastasis (0.021 and 0.012, respectively), as well as between baseline SII and disease stage and liver metastasis (0.026 and 0.018, respectively). Serum VEGF-A was significantly lower than the pretreatment level after 2 cycles of treatment (0.049) but was not different at progression (0.247). Baseline VEGF-A was correlated with the treatment response of first-line chemotherapy (0.001), while baseline SII was not (0.392). Kaplan-Meier survival analysis suggested that the PFS of first-line chemotherapy was significantly longer in the low-VEGF-A group at baseline than the high-VEGF-A group (11.37 vs. 6.17 months, 0.001). There was a trend toward longer PFS of first-line chemotherapy in the low-SII group at baseline than the high-SII group, but the difference was not significant (12.10 vs. 9.10 months, 0.050). Univariate and multivariate Cox regression analyses suggested that baseline VEGF-A (HR: 3.443, 95% CI: 1.330-8.908, 0.011) was an independent prognostic factor for PFS in SCLC patients. Baseline serum VEGF-A and SII are associated with important clinicopathological characteristics of SCLC patients. VEGF-A, but not SII, has the ability of diagnosis and predicting first-line chemotherapeutic efficacy and prognosis in SCLC patients.
评估血清血管内皮生长因子-A（VEGF-A）水平和全身免疫炎症指数（SII）在小细胞肺癌（SCLC）患者中的诊断和预测价值。2018年1月至2020年4月，我们前瞻性纳入了研究组59例未经治疗的SCLC患者和对照组50例非肿瘤患者。研究组在基线、化疗前两个周期后及病情进展时采集血样，对照组在入组时采集血样。采用化学发光法检测血清VEGF-A，根据全血细胞计数结果计算SII，并分析VEGF-A/SII与SCLC患者临床病理特征、化疗疗效及无进展生存期（PFS）的关系。SCLC患者基线血清VEGF-A显著高于非肿瘤患者（P=0.001），而基线SII则无显著差异（P=0.114）。SCLC患者基线VEGF-A与SII之间无相关性（P=0.123）；然而，基线VEGF-A与疾病分期及中枢神经系统（CNS）转移之间存在显著相关性（分别为P=0.021和P=0.012），基线SII与疾病分期及肝转移之间也存在显著相关性（分别为P=0.026和P=0.018）。治疗2个周期后血清VEGF-A显著低于治疗前水平（P=0.049），但病情进展时无差异（P=0.247）。基线VEGF-A与一线化疗的治疗反应相关（P=0.001），而基线SII则无相关性（P=0.392）。Kaplan-Meier生存分析表明，基线时低VEGF-A组一线化疗的PFS显著长于高VEGF-A组（11.37个月对6.17个月，P=0.001）。基线时低SII组一线化疗的PFS有长于高SII组的趋势，但差异不显著（12.10个月对9.10个月，P=0.050）。单因素和多因素Cox回归分析表明，基线VEGF-A（HR：3.443，95%CI：1.330-8.908，P=0.011）是SCLC患者PFS的独立预后因素。基线血清VEGF-A和SII与SCLC患者的重要临床病理特征相关。VEGF-A而非SII具有诊断和预测SCLC患者一线化疗疗效及预后的能力。
