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目的:研究血管生成拟态在非小细胞肺癌患者中的发生机制及其与化疗敏感性的关系。方法:收集42例NSCLC患者,分为早期组(I+II期,共19名)和晚期组(III+IV期,共23名)。20名接受手术治疗,22名仅行铂二联化疗,并且化疗组按2周期化疗疗效分有效组(疗效评价CR+PR,7名)和无效组(疗效评价SD+PD,15名)。对比分析VM与分期、化疗疗效、HIF-1α及各种临床病理特征是否有关。结果:早期组NSCLC患者VM阳性率明显高于晚期组(68.4%VS 26.1%,p=0.006),VM阳性组HIF-1α阳性率明显高于VM阴性组(P=0.034)。化疗有效组与无效组之间VM未见明显差异(P>0.05)。淋巴结转移及无远处转移组分别较无淋巴结转移及远处转移组VM阳性率高(P<0.05)。VM与患者性别、年龄、病理类型、肿瘤大小及分化程度无关(P>0.05)。结论:VM作为一种新发现的肿瘤供血方式,其形成主要在NSCLC早期,并且VM的存在与淋巴结转移有关,随着疾病进展,VM逐渐减少。目前尚未发现VM与NSCLC化疗敏感性有关,但HIF-1α在VM形成中起重要作用,VM有可能成为一个新的靶向治疗的靶点,为临床分期及诊疗提供帮助。
Objective: To investigate the mechanism of angiogenesis in non-small cell lung cancer and its relationship with chemosensitivity. Methods: Forty-two patients with NSCLC were enrolled and divided into three groups: early stage (stage I + II, total 19) and late stage (stage III + IV). Twenty patients were treated surgically and 22 patients were treated with platinum combined chemotherapy. The chemotherapy group was divided into two groups according to two cycles of chemotherapy (CR + PR, 7) and ineffective (SD + PD, 15). Comparisons of VM and staging, chemotherapy efficacy, HIF-1α and a variety of clinical and pathological features are related. Results: The positive rate of VM in early stage NSCLC was significantly higher than that in advanced stage (68.4% VS 26.1%, p = 0.006). The positive rate of HIF-1α in VM positive group was significantly higher than that in VM negative group (P = 0.034). There was no significant difference in VM between the effective group and the ineffective group (P> 0.05). The positive rate of VM in patients with lymph node metastasis and without distant metastasis was significantly higher than that without lymph node metastasis and distant metastasis (P <0.05). VM had no relation with patient’s sex, age, pathological type, tumor size and differentiation (P> 0.05). Conclusion: VM, as a newly discovered tumor blood supply, is mainly formed in the early stage of NSCLC. The presence of VM is associated with lymph node metastasis. As the disease progresses, VM gradually decreases. VM and NSCLC chemosensitivity has not yet been found, but HIF-1α plays an important role in the formation of VM. VM may become a new target of targeted therapy, which can help clinical staging and diagnosis.