夜间低氧对中晚期NSCLC患者血清VEGF及Ki67表达的影响及临床意义

发布时间：2018-03-31 01:29

  本文选题：夜间低氧　切入点：非小细胞肺癌　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨夜间低氧对中晚期NSCLC患者血清VEGF及Ki67表达的影响及临床意义。方法:通过腕式血氧仪监测64例经组织活检病理学初诊且未经治疗的中晚期非小细胞肺癌患者夜间血氧,依监测结果将患者分为夜间低氧组和非夜间低氧组,免疫组化法检测两组肺癌组织Ki67蛋白表达情况;于治疗前抽取空腹静脉血获取血清,酶联免疫吸附(ELISA)法检测各组血清血管内皮生长因子(Serum vascular endothelial growth factor,sVEGF)的水平。比较两组Ki67阳性率及sVEGF水平的差异,分析夜间低氧对Ki67阳性率、血清VEGF水平的影响,并讨论它们与各项临床参数之间的关系。结果:1、中晚期NSCLC患者夜间低氧发生率为45.3%(29/64),血氧水平在两组间比较存在显著差异(P=0.000),且在轻、中、重度夜间低氧组间两两比较,存在显著差异(P0.05);夜间低氧与患者年龄、性别、病理类型、TNM分期、远处转移情况无相关性(P0.05),与吸烟(P=0.027)、大体类型(P=0.031)显著相关,吸烟、中央型肺癌患者夜间低氧发生率高于不吸烟、周围型肺癌患者。2、两组间sVEGF水平、Ki67阳性率的差异有统计学意义(P=0.00),夜间低氧组sVEGF水平、Ki67阳性率均高于非夜间低氧组。3、sVEGF水平与患者性别、年龄、吸烟、病理类型、大体类型、TNM分期均无相关性(P0.05),而与远处转移显著相关(P=0.00),有远处转移者高于无远处转移者;Ki67阳性率与上述各临床参数均无明显相关性。4、相关性分析:Pearson相关分析显示sVEGF水平与Ki67阳性率呈正相关(P0.05)。结论:1.夜间低氧可促进中晚期NSCLC患者sVEGF和Ki67的表达。2.NSCLC患者sVEGF明显升高提示可能存在远处转移。3.NSCLC患者Ki67阳性率与sVEGF呈正相关,可能在肺癌的发生发展过程中起协同作用。
[Abstract]:Objective: to investigate the effect and clinical significance of nocturnal hypoxia on the expression of serum VEGF and Ki67 in patients with advanced NSCLC. Methods: 64 cases of non-small cell lung, newly diagnosed and untreated by histopathology, were monitored by wrist oxygenator. Cancer patients' nocturnal blood oxygen, Patients were divided into nocturnal hypoxia group and non-nocturnal hypoxia group according to the monitoring results. Immunohistochemical method was used to detect the expression of Ki67 protein in lung cancer tissues. The serum levels of vascular endothelial growth factor Serum vascular endothelial growth factors (VEGF) were detected by Elisa. The difference of Ki67 positive rate and sVEGF level between the two groups was compared, and the effect of nocturnal hypoxia on Ki67 positive rate and serum VEGF level was analyzed. Results the incidence of nocturnal hypoxia in the middle and late stage of NSCLC was 45.33 / 64%. There was a significant difference in blood oxygen level between the two groups, and there was significant difference between the two groups in the nocturnal hypoxia, and there was a significant difference between the light, moderate and severe nocturnal hypoxia groups, and there was a significant difference between the two groups in the nocturnal hypoxia. There was significant difference between nocturnal hypoxia and age, sex, pathological type, TNM stage, distant metastasis (P0.05), but significant correlation with smoking (P0.027), gross type (P0.031). Smoking, the incidence of nocturnal hypoxia in patients with central lung cancer was higher than that in non-smoking patients. The positive rate of sVEGF in peripheral lung cancer patients was significantly higher than that in nocturnal hypoxia group. The positive rate of sVEGF in nocturnal hypoxia group was higher than that in non-nocturnal hypoxia group and the patients' sex, age, smoking and pathological type. There was no significant correlation between TNM staging and distant metastasis (P 0.05), but there was no significant correlation between distant metastasis and distant metastasis. The positive rate of Ki67 in patients with distant metastasis was higher than that in patients without distant metastasis. There was no significant correlation between the positive rate of Ki67 and the clinical parameters mentioned above. The correlation analysis showed that the correlation analysis showed that there was no significant correlation between the positive rate and the clinical parameters mentioned above. Conclusion: 1. Nocturnal hypoxia can promote the expression of sVEGF and Ki67 in middle and late NSCLC patients. 2. The increase of sVEGF in NSCLC patients suggests that there may be distant metastasis. 3. Ki67 positive rate in NSCLC patients is positively correlated with sVEGF. It may play a synergistic role in the occurrence and development of lung cancer.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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