大肠癌中VEGF-C分泌水平的检测及其意义

Serum vascular endothelial growth factor-C level in patients with colorectal carcinoma and its clinical significance

目的检测大肠癌患者血清及不同的细胞系中血管内皮生长因子C(VEGF-C)和血管生长因子(VEGF)的分泌水平,评估其在诊断大肠癌淋巴结转移中的意义。方法采用酶联免疫法检测6 6例大肠癌(观察组)和3 0例健康者(对照组)血清中及4株大肠癌细胞系培养液中VEGF-C和VEGF的分泌的水平。结果观察组血清VEGF-C和VEGF均高于对照组(P<0.01);有淋巴结转移组的血清VEGF-C和VEGF均高于无淋巴结转移组(P<0.0 1);有淋巴管和/或血管浸润组上述两指标均高于无浸润组(P<0.0 1)。血清VEGF-C水平在1 4 3 8.0 pg/mL以上者其灵敏度为8 1.0%,特异性为7 6.0%;血清VEGF水平在2 4 0.2 pg/mL以上者其灵敏度为7 2.0%,特异性为7 4.0%。联合检测VEGF-C和VEGF对淋巴结转移阳性率的预测价值达8 4.6%,阴性预测价值达94.4%,精确度达9 3.7%。LoVo及LOVo-5 FU培养液中VEGF-C分泌水平明显升高(P<0.0 1)。结论检测VEGF-C为判断大肠癌患者淋巴结是否转移可能提供新的诊断依据。VEGF-C可望成为治疗大肠癌淋巴道转移的新靶点。

Objective To measure circulating vascular endothelial growth factor-C （VEGF-C） levels in patients with colorectal carcinoma, and assess the clinical significance in diagnosis of lymph node metastasis. Methods Sixty-six patients with colorectal carcinoma and 30 healthy control patients were included in this study. Circulating VEGF-C and VEGF levels were assessed by enzyme-linked immunosorbent assay. Results Serum VEGF-C and VEGF concentration was higher in patients with colorectal carcinoma than in healthy control patients （ P 〈 0. 01 ）. Patients with lymph node metastasis revealed higher serum VEGF-C and VEGF concentrations than those without hymph node metastasis （ P 〈 0. 01 ）. The level of VEGF-C and VEGF in lymphatic vessel invasion and venous invasion was higher in the group with invasion than in the group without invasion （ P 〈 0.01 ）. Serum VEGF- C levels reached a sensitivity of 81. 0 % and a specificity of 76.0% with a cutoff value of 1438. 0 pg/mL, whereas VEGF levels reached 72. 0% sensitivity and 74.0% specificity at 240. 2 pg/mL. With combined determination of VEGF-C and VEGF levels, the positive predictive value was 84. 6%, the negative predictive value was 94. 6%, and accuracy was 93.7%. Conclusions Circulating VEGF-C levels may provide additional information for distinguishing between the absence or presence of lymph node metastasis in patients with colorectal carcinoma. VEGF-C can become a new target spot in the treatment of lymphatic metastasis in patients with colorectal cancer.