目的 探讨胸腔积液及血清中血管生成素-2(Ang-2)与肺腺癌合并恶性胸腔积液(MPE)患者胸腔积液局部控制及预后的关系.方法 收集肺腺癌合并MPE患者的胸腔积液及血液标本,采用ELISA法测定胸腔积液和血清中Ang-2水平,分析其与临床病理特征、胸腔积液局部控制情况及预后的关系.结果 胸腔积液和血清Ang-2水平分别为(26.67±8.82) pg/ml和(361.18±97.58) pg/ml.采用ROC曲线分析,当截断值为25.57 pg/ml时,胸腔积液Ang-2水平预测胸腔积液局部控制情况效能为最佳.Logistic回归分析显示胸腔积液Ang-2水平是胸腔积液局部控制情况的独立因素(OR=5.65,95％CI:2.40～ 16.78,P＜0.001).Cox多因素分析表明胸腔积液Ang-2水平(HR=1.15,95％CI:1.01～1.32)及胸腔积液局部控制情况(HR=0.42,95％CI:0.19～0.89)是影响肺癌合并MPE患者生存预后的独立因素.血清Ang-2水平与胸腔积液局部控制情况及预后无关(P＞0.05).结论 胸腔积液Ang-2水平可作为肺腺癌合并MPE患者预测胸腔积液局部控制及判断预后的分子标志物,具有重要的临床应用价值.%Objective To investigate the role of angiopoietin-2 (Ang-2) in control of malignant pleural effusions (MPE) and prognosis in patients with primary lung adenocarcinoma.Methods Using enzyme-linked immunoadsorbentassay,the levels of Ang-2 were measured in both pleural effusions (PE) and serum from a total of 79 lung adenocarcinoma patients with MPE.Data was analyzed with the efficacy of MPE control and prognosis.Results The level of Ang-2 in PE was (26.67±8.82) pg/ml,and (361.18±97.58) pg/ml in serum.Ang-2 level in PE was the only one significant factor for MPE control when comparing with other demographic and laboratory data.Ang-2 ≥ 25.57 pg/ml in PE was used as a cut-off point for failure control of MPE.Logistic regression analysis showed that the level of Ang-2 in PE was an independent factor in the local control of PE (OR =5.65,95％ CI:2.40-16.78,P＜ 0.001).In a multivariate analysis,the level of Ang-2 in PE (HR=1.15,95％CI:1.01-1.32) and MPE control status (HR=0.42,95％CI:0.19-0.89) were confirmed as independent prognostic factors for overall survival.Conclusion The level of Ang-2 in PE appears to be a reliable surrogate marker in evaluating the therapeutic efficacy in the control of MPE and prognosis.
展开▼
