恶性脑胶质瘤同步放化疗后血清TGF-β和GFAP浓度变化及其临床意义

摘要

目的 探讨脑胶质瘤患者治疗后血清TGF-β和GFAP浓度的变化对其预后的影响.方法 选择Ⅲ～Ⅳ级脑胶质瘤患者56例,采用术后三维适形放疗联合口服替莫唑胺化疗.分别于术前、术后1周和放化疗结束后抽取患者静脉血3 ml检测血清TGF-β和GFAP浓度.结果 Ⅲ级脑胶质瘤患者血清TGF-β浓度显著低于Ⅳ级脑胶质瘤患者,差异有统计学意义(P＜0.05);Ⅲ级脑胶质瘤患者血清GFAP浓度显著高于Ⅳ级脑胶质瘤患者,差异有统计学意义(P＜0.05).与术前比较,术后1周和放化疗结束后患者血清TGF-β和GFAP浓度显著降低,差异有统计学意义(P＜0.05);与术后1周比较,放化疗结束后患者血清TGF-β和GFAP浓度显著降低,差异有统计学意义(P＜0.05).不同疗效组患者血清TGF-β和GFAP浓度差异显著(P＜0.05);与CR组比较,SD、PD组患者血清TGF-β浓度显著升高,PR、SD、PD组患者血清GFAP浓度显著升高,差异有统计学意义(P＜0.05);与PR组比较,SD、PD组患者血清TGF-β和GFAP浓度均显著升高,差异有统计学意义(P＜0.05);与SD组比较,PD组患者血清TGF-β和GFAP浓度均显著升高,差异有统计学意义(P＜0.05).结论 TGF-β和GFAP是评估脑恶性胶质瘤疗效及预后的良好血清标志物,具有重要的临床价值.%Objective To investigate the serum TGF-β and GFAP concentration changes in patients with malignant brain glioma and its influence on prognosis.Methods A total of 56 cases of stage Ⅲ ～ Ⅳ brain glioma patients were selected.All the patients used postoperative three dimensional conformal radiotherapy combined with oral administration of chemotherapy for treatment.The serum TGF-β and GFAP at the preoperative,postoperative 1 week and after the end of radiochemotherapy were detected.Results The serum TGF-βconcentration of grade Ⅲ brain glioma patients was significantly lower than that of the grade Ⅳ glioma patients and the difference was statistically significant (P ＜ 0.05).The level of serum GFAP in patients with grade Ⅲ glioma was significantly higher than that in patients with grade Ⅳ gliomas,and the difference was statistically significant (P ＜ 0.05).Compared with the preoperative,the serum TGF-β and GFAP concentration decreased significantly at 1 week postoperative chemotherapy and after radiochemotherapy,the differences were statistically significant (P ＜ 0.05).Compared with 1 weeks after surgery,serum TGF-βand GFAP concentrations were significantly decreased in patients after radiochemotherapy,and the difference was statistically significant (P ＜ 0.05).The difference of serum levels of TGF-β and GFAP concentration was statistically significant (P ＜ 0.05).Compared with the CR group,serum TGF-β concentration in patients of SD and PD group increased significantly,and serum GFAP concentration in patients of PR,SD,PD groups increased significantly,the differences were statistically significant (P ＜ 0.05).Compared with the PR group,the serum levels of TGF-β and GFAP were significantly increased in patients of SD and PD group,and the difference was statistically significant (P ＜ 0.05).Compared with the SD group,the serum levels of TGF-β and GFAP were significantly increased in patients of PD group,and the difference was statistically significant (P ＜ 0.05).Conclusion TGF-β and GFAP are good serum markers for the evaluation of the curative effect and prognosis of brain malignant glioma,which has important clinical value.