膀胱癌患者血清血管内皮生长因子水平测定的临床意义

The clinical value of serum VEGF measurement in patients with bladder cancer

目的探讨膀胱癌(BC)患者血清血管内皮生长因子(VEGF)水平与BC分期、分级的关系及手术前后变化的临床意义。方法采用酶联免疫吸附试验(ELISA)对62例BC患者术前、术后1个月、术后出现复发(19例)或远处转移(2例)者、50例正常人血清中VEGF水平进行检测。结果BC组的血清VEGF水平(269·2±58·3)ng/L明显高于正常对照组(125·5±22·3)ng/L(P<0·01),并与肿瘤的分期、分级相关;其中浸润性癌T2-T3(275·7±41·2)ng/L组明显高于浅表性癌Tis-T1(214·6±32·4)ng/L组(P<0·01),浸润性癌T4(338·8±43·7)ng/L组明显高于T2-T3组(P<0·01),G3级VEGF水平(332·9±45·6)ng/L显著高于G1级(231·2±38·5)ng/L和G2级(252·6±45·3)ng/L,G1级和G2级之间差异无统计学意义。与术前相比,术后血清VEGF水平(142·4±31·8)ng/L明显下降(P<0·01),而术后复发及转移组血清VEGF水平(256·3±93·2)ng/L再次明显上升高于正常对照组(P<0·01)。结论VEGF表达与膀胱癌的临床分期及病理分级相关,血清VEGF水平可作为膀胱癌患者手术前后病情监测及判断复发的一个新瘤标。

Objective To search for the relation of the serum VEGF to the staging and grading of bladder cancer,and the clinical value of the VEGF changes preand postoperation.Methods There are two groups,named bladder cancer group(62 cases) and contral group(50 cases) which consisted of normal people.The ELISA method was taken to measure serum VEGF.In bladder cancer group,there are 41 patients with BC、19 patients with recurrence postoperation and 2 patients with distant metastasis.The total 62 cases were measured for the level of serum VEGF at one months pre-and postoperation;after recurrence and distant inetastasis respectively.Results The serum VEGF of BC group(269.2±58.3) ng/L is higher statistically compared to norrmal contral group(125.5±22.3) ng/L(P<0.01),and relates to the staging and grading of tumors.The differencs is statistically significant between T2-T3(275.7±41.2) ng/L and Tis-T1(214.6±32.4) ng/L(P<0.01),T4(338.8±43.7) ng/L and T2-T3(P<0.01).The VEGF of G3(332.9±45.6) ng/L elivated significantly compared to G1 and G2.The difference of VEGF between G1(231.2±38.5) ng/L and G2(252.6±45.3) ng/L is not significant statistically.Compared to preoperation,the serum VEGF(142.4±31.8)ng/L decreased significantly postoperation.When the bladder cancer recurre or metastated distantly postoperation,the serum VEGF(256.3±93.2) ng/L increased again to a statistical significance level compared to the normal contral group(P<0.01).Conclusion The expression of VEGF relates to the clinical staging and pathological grading of bladder cancer.Serum VEGF is a new tumor marker of bladder cancer for surveillance of the patients perioperation,and for ausssing the bladder cancer recourrence.