Salven P, Ruotsalainen T, Mattson K, Joensuu H
Department of Oncology, Helsinki University Central Hospital, Finland.
Int J Cancer. 1998 Apr 17;79(2):144-6. doi: 10.1002/(sici)1097-0215(19980417)79:2<144::aid-ijc8>3.0.co;2-t.
Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and vascular permeability. Increased serum VEGF concentrations (S-VEGF) have been found in patients with various types of human cancer, including cancer of the lung. However, the clinical and prognostic significance of S-VEGF in cancer is unknown. We measured S-VEGF, using enzyme-linked immunosorbent assay, in sera taken from 68 untreated patients with small-cell lung cancer (SCLC) at the time of diagnosis. The patients were treated with 6 cycles of cisplatin and etoposide, and were randomly assigned to receive recombinant interferon, leukocyte interferon or neither. S-VEGF ranged from 70 to 1738 pg/ml (mean, 527 pg/ml). The patients who achieved partial or complete response to treatment had lower pre-treatment S-VEGF than the non-responding patients (p = 0.0083, Mann-Whitney test). High (>527 pg/ml) S-VEGF was associated with poor survival (p = 0.012, Log Rank Test), and all 3-year survivors had lower than mean pre-treatment S-VEGF. In a multivariate analysis, S-VEGF and stage were the only independent prognostic factors, and the estimated 3-year survival of the patients with limited stage disease and low pretreatment S-VEGF (n = 17, 25% of all patients) was 41% (p = 0.0055, log rank test). These data show that high pretreatment S-VEGF is associated with poor response to treatment and unfavourable survival in patients with SCLC treated with combination chemotherapy with or without interferon.
血管内皮生长因子（VEGF）是血管生成和血管通透性的重要调节因子。在包括肺癌在内的各类人类癌症患者中，均发现血清VEGF浓度（S-VEGF）升高。然而，S-VEGF在癌症中的临床和预后意义尚不清楚。我们采用酶联免疫吸附测定法，对68例未经治疗的小细胞肺癌（SCLC）患者诊断时采集的血清进行了S-VEGF检测。患者接受了6个周期的顺铂和依托泊苷治疗，并被随机分配接受重组干扰素、白细胞干扰素治疗或不接受任何治疗。S-VEGF范围为70至1738 pg/ml（均值为527 pg/ml）。治疗取得部分或完全缓解的患者，其治疗前S-VEGF低于未缓解患者（曼-惠特尼检验，p = 0.0083）。高S-VEGF（>527 pg/ml）与生存率低相关（对数秩检验，p = 0.012），所有3年幸存者的治疗前S-VEGF均低于均值。多因素分析显示，S-VEGF和分期是仅有的独立预后因素，局限期疾病且治疗前S-VEGF低的患者（n = 17，占所有患者的25%）的估计3年生存率为41%（对数秩检验，p = 0.0055）。这些数据表明，对于接受联合化疗（无论是否使用干扰素）治疗的SCLC患者，治疗前高S-VEGF与治疗反应差和生存不良相关。
