肺癌支气管肺泡灌洗液中内皮抑素的表达

摘要

目的 探讨肺癌病人术前血清及支气管肺泡灌洗液(BALF)中内皮抑素(endostatin)表达情况,分析其与肿瘤临床病理特征和预后的关系.方法 酶联免疫吸附(ELISA)法检测57例肺癌及34例肺良性病变者术前血清及BALF中endostatin含量.结果 肺癌病人血清及BALF术前内皮抑素含量显著高于肺良性病变者,差异有统计学意义(P＜0.05).淋巴结及远处转移组术前内皮抑素含量明显高于无转移组(P＜0.05);肺腺癌病人外周血清及BALF中内皮抑素表达高于鳞癌、小细胞癌者;Ⅲ～Ⅳ期病人血清、BALF内皮抑素水平高于Ⅰ～Ⅱ期者(P＜0.01).肺癌病人内皮抑素在外周血清及BALF中的表达呈线性正相关(P=0.000).结论 肺癌病人血清及支气管肺泡灌洗液中内皮抑素含量明显高于良性病变者,且与肿瘤组织学类型、分化程度、TNM分期、淋巴结转移呈明显正相关,肺泡灌洗液中内皮抑素含量较血清中高且更敏感,可能有助于肺癌病人预后的评估及肿瘤分化程度判断.%Objective To evaluate the expression of endostatin in bronchoalveolar lavage fluid (BALF) and serum in patients with lung cancer, and to analysis the relationship between endostatin expression and clinical prognosis as well as pathophysiological characteristics. Methods The samples of serum and BALF were obtained from 57 patients with untreated primary lung cancer ( lung cancer group) and 27 patients with benign pulmonary diseases (control group). The levels of endostatin were analyzed by enzyme-linked immunosorbent assay (ELISA). Results The expression of endostatin in serum and BALF in lung cancer group was significantly higher than that in control group ( P ＜0. 01 ). The levels of endostatin in serum and BALF in late-stage ( stage Ⅲ or Ⅳ ) lung cancer patients were significantly higher than that in early-stage ( stage Ⅰ or Ⅱ , P ＜ 0. 01 ).The expression of endostatin both in serum and BALF were significantly higher in adenocarcinoma patients than that in squamous cell carcinoma or SCLC patients. Endostatin concentrations in BALF and serum were significantly greater in patients with lymph node and distant metastasis than those patients without. the expressions of endostatin in serum were closely related to that in BALF in patients with lung cancer ( P = 0. 000). Conclusion The expression of endostatin in serum and in BALF is higher in lung cancer than benign pulmonary diseases and it was associated with TNM stage, lymph node metastasis and clinicopatholgical variables. The level of endostatin in BALF is higher than that in serum and may be used as a significant marker to direct clinic therapy and estimation of prognosis.