术前血清sICAM-1和VEGF的表达水平对胃癌患者预后的判断价值

Prognosis predicting significance of preoperative serum intercellular adhesion molecule-1 and vascular endothelial growth factor expression in patients with grastric cancer

目的研究胃癌患者术前血清可溶型细胞间粘附分子-1(sICAM-1)和血管内皮生长因子(VEGF)表达与临床病理学参数、术后肿瘤复发和生存率的关系。方法运用ELISA法定量检测sICAM-1和VEGF在胃癌及正常人血清中含量。结果 胃癌组术前血清sICAM-1和VEGF水平高于健康人组(P<0.01),术后1周血清sICAM-1水平显著下降(P<0.01),VEGF无明显变化(P>0.05);胃癌组术前血清sICAM-1和VEGF水平,在浆膜侵及者均高于未侵及者(P<0.05和<0.01),在TNMⅢ期、Ⅳ期者高于TNMⅠ期、Ⅱ期者(P均<0.01);伴淋巴结转移组血清sICAM-1水平高于不伴有淋巴结转移组(P<0.01),血清VEGF、水平与淋巴结转移状态无关(P>0.05);胃癌组术前sICAM-1和VEGF水平高表达者容易出现肿瘤复发(P<0.005),其二年生存率亦较低表达者低(P<0.005);两者与患者组织学分型、性别、年龄等无关(P均>0.05)。结论 血清sICAM-1和VEGF可能参与胃癌发生、发展和侵润、转移的调控。联合检测可能有助于预测胃癌是否发生淋巴结转移及侵润程度,可作为术前判断胃癌患者预后的指标。

Objective To determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-l)and vascular endothelial growth factor(VEGF) and to elucidate the relation of their levels with clinical characteristics,recurrence and survival rate. Methods Serum sICAM-1 and VEGF levels were measured by the guantitative sandwich ELISA in gastric cancer patients(60 cases of preoperative patients and 15 cases of postoperative patients)and 15 cases of healthy individuals. Results The preoperative serum sICAM-1 and VEGF levels in gastric cancer patients were significantly higher than those in healthy subjects(P<0. 01), serum sICAM-1 levels in post-operative one week patients were significantly lower(P<0. 01) ,but serum VEGF levels were similar to pre-operative levels(P>0. 05). sICAM-1 and VEGF levels of patients with serosal invasion were higher than those of patients without serosal invasion(P<0. 05 or <0. 01). Both levels of stage Ⅲ and stage Ⅳ were significantly higher than those of stage Ⅰ and stage Ⅱ (P<0. 01). Serum sICAM-1 was significantly correlated to lymph-node metastasis (P<0. 01) , but no correlation was observed between lymph-node metastasis and VEGF. It was found that patients with high serum sICAM-1 and VEGF had higher recurrence rates and lower 2-year survival rate much. than those with low sICAM-1 and VEGF(P<0. 005) , Both sl-CAM-1 and VEGF were not significantly correlated to histologic types, sex and age (P> 0.05). Conclusion Serum sICAM-1 and VEGF may play an important role in the growth and metastasis of gastric cancer,and codetermination of sICAM-1 and VEGF probably is valuable in predicting lymph-node metastasis, depth of invasion and prognosis.