临床肿瘤学杂志

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晚期乳腺癌患者血清VEGF和MMP-9表达与化疗疗效的关系

李莉1,刘德林2,武渊2,王友群1,孙蔚莉2
  

  1. 1 中国药科大学临床药学教研室 2 江苏省肿瘤医院肿瘤内科
  • 收稿日期:2015-09-09 修回日期:2015-11-02 出版日期:2015-12-31 发布日期:2015-12-31
  • 通讯作者: 孙蔚莉

Relationship between the levels of VEGF, MMP-9 and chemotherapy effect in patients with advanced breast cancer

LI Li, LIU Delin, WU Yuan, WANG Youqun, SUN Weili.   

  1. Department of Clinical Pharmacy, China Pharmaceutical University
  • Received:2015-09-09 Revised:2015-11-02 Online:2015-12-31 Published:2015-12-31
  • Contact: SUN Weili

摘要: 目的 探讨晚期乳腺癌患者化疗前后血清血管内皮生长因子(VEGF)和基质金属蛋白酶-9(MMP-9)表达水平的变化与化疗疗效的关系。方法 收集2012年12月1日至2014年12月1日江苏省肿瘤医院收治的65例晚期乳腺癌患者。全组患者均接受两药联合化疗方案,其中含铂方案39例,非含铂方案26例。在治疗前和化疗2个周期后,抽取患者的血清样本,检测VEGF和MMP-9的表达水平。比较化疗前后、不同疗效及不同化疗方案间血清VEGF和MMP-9的表达水平,并分析化疗后不同VEGF和MMP-9表达水平患者的中位疾病进展时间(TTP)。结果 65例乳腺癌患者化疗前VEGF的均值为596.5 pg/ml,MMP-9均值为686.5 ng/ml,显著高于化疗后的215.0 pg/ml和500.4 ng/ml,差异均有统计学意义(P<0.05)。56例临床获益患者化疗前后VEGF水平分别为678.1 pg/ml和232.0 pg/ml(P<0.05),MMP-9水平分别为679.3 ng/ml和450.6 ng/ml(P<0.05);9例疾病进展者化疗前后VEGF和MMP-9水平的差异无统计学意义(P>0.05)。39例接受含铂方案的患者,化疗前后MMP-9的均值分别为742.6 ng/ml和451.7 ng/ml(P<0.05),VEGF水平在化疗前后差异无统计学意义(P>0.05)。26例接受非含铂方案的患者,化疗前后VEGF和MMP-9水平的差异均无统计学意义(P>0.05)。化疗后30例MMP-9表达水平下降者的中位TTP为5.0个月,优于25例上升者的3.0个月(P<0.05);化疗后VEGF表达水平下降者与上升者的中位TTP比较,差异无统计学意义(P>0.05)。
结论 VEGF和MMP-9表达水平降低可能是晚期乳腺癌患者化疗有效的参考指标。

Abstract: Objective To study the relationship between the change of expression levels of vascular endothelial growth factors(VEGF)and matrix metalloproteinase-9(MMP-9)of advanced breast cancer patients before and after chemotherapy and the chemotherapy response. Methods Sixty-five advanced breast cancer patients in Jiangsu Cancer Hospital from December 1 2009 to December 1 2014 were enrolled in this study. All the patients were infused with two agents chemotherapy, in which 39 were with platinumbased regimen and 26 received nonplatinumbased regimen. Serum samples were collected from the 65 patients respectively before chemotherapy and after 2 cycles chemotherapy to determine the expression levels of VEGF and MMP-9. The expression levels of VEGF and MMP-9 were compared before and after chemotherapy, between platinum-based regimen and non-platinum-based regimen as well as between different efficacies. Meanwhile the median time to progress(TTP) of different expression of VEGF and MMP-9 were evaluated after chemotherapy.
Results The mean value of serum VEGF and MMP-9 were 596.5 pg/ml and 686.5 ng/ml before chemotherapy, higher than 215.0 pg/ml and 500.4 ng/ml after chemotherapy(P<0.05). The expression level of VEGF of 56 patients with clinical benefit before and after chemotherapy was 678.1 pg/ml and 232.0 pg/ml(P.0.05), while the expression level of MMP-9 was 679.3 ng/ml and 450.6 ng/ml(P<0.05). Those indexes in 9 patients with disease progression had no differences before and after chemotherapy (P>0.05). In 39 patients with platinum-based chemotherapy, the mean value of MMP-9 after chemotherapy were 451.7 ng/ml, lower than 742.6 ng/ml before chemotherapy(P<0.05). The median TTP of 30 patients with decreased level of MMP-9(5.0 months)was superior to the 25 patients with increased level of MMP-9(3.0 months) with significant difference (P<0.05); whereas there was no significant difference between patients with the decreased and increased level of VEGF(P>0.05). Conclusion The decline of serum VEGF and MMP-9 expression levels may be a index of effective chemotherapy in advanced breast cancer.

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