结直肠癌患者血清淋巴管内皮生长因子检测及其临床意义

Serum Vascular Endothelial Growth Factor-C and Vascular Endothelial Growth Factor Level in Patients with Colorectal Carcinoma and Their Clinical Significance

目的检测结直肠癌患者血清淋巴管内皮生长因子(VEGF-C)和血管内皮生长因子(VEGF)的水平,评估它们作为诊断和监测结直肠癌患者淋巴结转移指标的临床意义。方法应用酶联免疫吸附试验(ELISA)检测66例结直肠癌患者、22例健康对照者血清中VEGF-C和VEGF的水平。结果结直肠癌患者血清VEGF-C的浓度为(1 688.02±325.02)pg/ml,明显高于健康对照组[(948.68±250.52)pg/ml](P<0.01)。结直肠癌淋巴结转移组血清VEGF-C的浓度高于无淋巴结转移组;按照有无淋巴管浸润和血管浸润分组,VEGF-C水平在浸润组中高于无浸润组。血清VEGF-C水平>1 439.7 pg/ml预测淋巴结转移的灵敏度和特异性分别达80.0%和77.8%;而血清VEGF水平>237.2pg/ml预测淋巴结转移的灵敏度和特异性分别达73.3%和72.2%;VEGF-C和VEGF水平联合检测,淋巴结转移阳性率的预测价值达84.6%,而阴性率的预测价值达94.7%。结论血清VEGF-C水平可为结直肠癌患者淋巴结是否转移提供新的诊断依据。血清VEGF-C和VEGF水平的联合检测可作为结直肠癌患者术前临床分期的重要指标。

Objective To measure circulating vascular endothelial growth factor-C（VEGF-C）and vascular endothelial growth factor（VEGF）levels in patients with colorectal carcinoma,and assess their clinical significance as a diagnostic tool for determining lymph node metastasis.Methods In 66 patients with colorectal carcinoma and 22 healthy controls,circulating VEGF-C and VEGF levels were assessed by enzyme-linked immunosorbent assay.Results Serum VEGF-C and VEGF levels were higher in patients with colorectal carcinoma than in healthy controls.Patients with lymph node metastasis revealed higher serum VEGF-C and VEGF levels than those without lymph node metastasis.The levels of VEGF-C and VEGF in the patients with lymphatic vessel invasion and venous invasion were higher than in those without invasion.Serum VEGF-C levels reached a sensitivity of 80.0% and a specificity of 77.8% with a cutoff value of 1 439.7 pg/ml,whereas VEGF levels reached 73.3% sensitivity and 72.2% specificity at 237.2 pg/ml.By th多e combined detection of VEGF-C and VEGF levels,the positive and negative predictive value for lymph node metastasis was 84.6% and 94.7% respectively.Conclusion Circulating VEGF-C levels may provide additional information for judgment of lymph node metastasis in patients with colorectal carcinoma.The combined detection of VEGF-C and VEGF levels can be acted as an important index for clinical stage of colorectal carcinoma.