Vascular endothelial growth factor C complements the ability of positron emission tomography to predict nodal disease in lung cancer.
Vascular endothelial growth factor C complements the ability of positron emission tomography to predict nodal disease in lung cancer.
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DOI：
10.1016/j.jtcvs.2015.08.001
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Mulligan MS
中科院分区：
文献类型：
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作者：
Farjah F;Madtes DK;Wood DE;Flum DR;Zadworny ME;Waworuntu R;Hwang B;Mulligan MS
血管内皮生长因子（vegf） C和D是生物学上合理的淋巴结疾病标志物，可以提高肺癌分期的准确性。我们假设这些生物标志物将提高正电子发射断层扫描（PET）预测疑似或确诊非小细胞肺癌（NSCLC）患者淋巴结疾病的能力。一项横断面研究（2010-2013）对前瞻性纳入肺结节生物库的患者进行了研究，通过计算机断层扫描（CT）和PET分期，并进行了病理结节评估。采用酶联免疫吸附法测定麻醉前抽取的血浆中的生物标志物水平。采用似然比检验比较以下logistic回归预测模型：ModelPET、ModelPET/VEGF-C、ModelPET/VEGF-D和ModelPET/VEGF-C/VEGF-D。为了解释5个计划的两两比较，P值< 0.01被认为是显著的。在62例患者中（中位年龄67岁，48%为男性，87%为白人，84%为非小细胞肺癌），58%的患者在肺门和/或纵隔淋巴结有氟脱氧葡萄糖摄取。病理证实的淋巴结转移率为40%。预测模型的比较结果如下：ModelPET/VEGF-C与ModelPET (P = 0.0069)， ModelPET/VEGF-D与ModelPET (P = .1886)， ModelPET/VEGF-C/VEGF-D与ModelPET (P = 0.0146)， ModelPET/VEGF-C/VEGF-D与ModelPET/VEGF-C (P = .2818)， ModelPET/VEGF-C/VEGF-D与ModelPET/VEGF-D （P = 0.0095）。在ModelPET/VEGF-C中，较高的VEGF-C水平与淋巴结疾病风险增加相关（优势比为2.96；95%置信区间为1.26-6.90）。血浆VEGF-C水平补充了PET预测疑似或确诊NSCLC患者淋巴结疾病的能力。VEGF-D没有改善预测。
Vascular endothelial growth factors (VEGFs) C and D are biologically rational markers of nodal disease that could improve the accuracy of lung cancer staging. We hypothesized that these biomarkers would improve the ability of positron emission tomography (PET) to predict nodal disease among patients with suspected or confirmed non–small cell lung cancer (NSCLC). A cross-sectional study (2010–2013) was performed of patients prospectively enrolled in a lung nodule biorepository, staged by computed tomography (CT) and PET, and who underwent pathologic nodal evaluation. Enzyme-linked immunosorbent assay was used to measure biomarker levels in plasma from blood drawn before anesthesia. Likelihood ratio testing was used to compare the following logistic regression prediction models: ModelPET, ModelPET/VEGF-C, ModelPET/VEGF-D, and ModelPET/VEGF-C/VEGF-D. To account for 5 planned pairwise comparisons, P values<.01 were considered significant. Among 62 patients (median age, 67 years; 48% men; 87% white; and 84% NSCLC), 58% had fluorodeoxyglucose uptake in hilar and/or mediastinal lymph nodes. The prevalence of pathologically confirmed lymph node metastases was 40%. Comparisons of prediction models revealed the following: ModelPET/VEGF-C versus ModelPET (P = .0069), ModelPET/VEGF-D versus ModelPET (P = .1886), ModelPET/VEGF-C/VEGF-D versus ModelPET (P = .0146), ModelPET/VEGF-C/VEGF-D versus ModelPET/VEGF-C (P = .2818), and ModelPET/VEGF-C/VEGF-D versus ModelPET/VEGF-D (P = .0095). In ModelPET/VEGF-C, higher VEGF-C levels were associated with an increased risk of nodal disease (odds ratio, 2.96; 95% confidence interval, 1.26–6.90). Plasma levels of VEGF-C complemented the ability of PET to predict nodal disease among patients with suspected or confirmed NSCLC. VEGF-D did not improve prediction.