血浆血管内皮生长因子含量测定对胃癌的诊断价值

Value of plasma vascular endothelial growth factor in diagnosis of gastric cancer

目的探讨血管内皮生长因子(VEGF)在胃癌诊断中的价值。方法用时间分辨荧光免疫分析(TRFIA)技术对92例胃癌、36例胃良性病变(10例胃溃疡和26例胃炎)和92例正常人血浆VEGF含量进行测定,分析不同临床病理特性与VEGF含量的相关性,并用受试者工作特征(ROC)曲线分析VEGF对胃癌诊断的临床价值。结果血浆VEGF含量在胃癌和胃良性病变组呈非正态分布,与正常对照组相比,胃癌和胃良性病变组都显著增高,但胃良性病变组增高幅度不及胃癌组;血浆VEGF含量与性别、年龄、肿瘤位置(胃窦、胃体、幽门)、组织类型、分化程度及肿瘤分级无相关性,与TNM分期、有无淋巴结和远处转移显著相关;以217.79 pg/mL为临界值,血浆VEGF诊断胃癌的灵敏度为40.2%,特异性为93.7%,诊断准确率为69.9%。结论血浆VEGF含量与胃癌的临床病理特性相关,检测血浆VEGF含量对胃癌诊断有一定价值。

Objective To determine the value of plasma vascular endothelial growth factor （VEGF） in the diagnosis of gastric cancer. Methods Plasma VEGF concentrations were measured by time-resolved fluoroimmunoassay （TRFIA） in 92 healthy controls, in 36 benign stomach disease patients, and in 92 gastric cancer patients before surgery. The association between plasma VEGF levels and clinicopathological features were evaluated. Data from healthy controls, benign stomach disease patients and gastric cancer patients were assessed by calculate receiver operating characteristic （ROC） curves. Results The plasma VEGF levels with abnormal distribution were higher in gastric cancer patients than in healthy controls. Plasma VEGF levels were significant associated with the presence of distant metastases, lymph node metastases and tumor stage, but not with tumor location, tumor histology, differentiation, the depth of tumor invasion. At the cutoff of 217.79 pg/mL, the diagnostic sensitivity, specificity and accuracy of the TR-FIA were 40.2% , 93. 7% and 69.9% , respectively. Conclusion Plasma VEGF levels are significantly associated with the presence of distant metastases, lymph node metastases and tumor stage. The results suggest that determination of plasma VEGF levels may be clinically useful.