血清血管内皮生长因子水平检测在结肠癌临床诊疗中的价值

Value of detection for serum VEGF levels in clinical diagnosis and curative effect on colon cancer

目的探讨血清血管内皮生长因子（VEGF）在结肠癌患者诊疗中的价值。方法采用酶联免疫吸附（ELISA）双抗体夹心法检测66例结肠癌患者、55例结肠良性疾病患者及50名健康体检人员的血清VEGF，化学发光法检测其血清癌胚抗原（CEA）、糖类抗原199（CAl99）的含量，评价VEGF单项及联合检测对结肠癌的诊断价值，分析结肠癌患者血清VEGF水平与临床病理特征、疗效和预后的关系。结果结肠癌组患者手术前血清VEGF水平（318．5±148．6）ng／L明显高于结肠良性病组（136．9±52．6）ng／L、健康对照组（125．7±49．4）ng／L，差异均有统计学意义（t值分别为8．830，8．805，均P〈0．01）；血清VEGF水平在肿瘤直径≥3em组、累及浆膜组、TNM分期Ⅲ＋Ⅳ组及有淋巴结转移组分别为（394．3±119．2）、（436．5±132．1）、（446．0±148．7）、（386．7±114.3）ng／L，均显著高于肿瘤直径〈3cm组、未及浆膜组、I＋Ⅱ分期组及无淋巴结转移组的（287．6±89．3）、（211．5±69．4）、（252．9±74．5）、（245．2-4-70．8）ng／L，差异均有统计学意义（t值分别为3．517、8．969、5．726、6．222，均P〈0．01）；结肠癌患者血清VEGF、CEA及CAl99检测的敏感度分别为61％、45％及53％，3项指标联合检测的敏感度可提高至86％，明显优于单项VEGF检测的敏感度（χ2=11．237，P〈0．01）；66例结肠癌患者手术治疗后第3、7、10天的血清VEGF水平[（272.3±88．1）、（236．8±77．4）、（173．1±59．9）ng／L]呈逐步下降趋势，与手术前[（318．5±148．6）ng／L]比较差异均有统计学意义（t值分别为2．173、3．961、7．464，均P〈0．05）。结论结肠癌患者血清VEGF与肿瘤的发生、发展及转移密切相关，血清VEGF检测对结肠癌的临床诊断、疗效观察及预后判断有重要应用价值。

Objective To investigate the clinical value of serum VEGF levels in the diagnosis and treatment of colon cancer. Methods Serum VEGF was detected by ELISA, and CEA and CA199 concentration were detected by CLEIA in 66 patients with colon cancer, 55 patients with colon benign diseases and 50 health persons. The value of individual and joint detection for VEGF in-colon cancer was evaluated. Analysis had been done on relationships between serum VEGF and pathology, treatment effects and prognosis. Results The levels of serum VEGF in colon cancer group [（318.5±148.6） ng/L] were significantly higher than those in control group [（125.7±49.4） ng/L] and benign colon diseases [（136.9±52.6） ng/L] （t = 8.830, 8.805, all P 〈 0.01）. There was a positive correlation between serum levels of VEGF and depth of tumor size, tumor invasion, lymph node metastasis and TNM stage （P 〈 0.01）. The susceptibilities of VEGF, CEA, CA199 were 61%, 45 %, 53 %. The sensitivity of detection was improved to 86 % when the combined detection of VEGF, CEA and CA199 （χ2 =11.237, P 〈 0.01）. The serum levels of VEGF in patients with colon cancer was significantly decreased after treatment in the 3, 7, 10 day compared with that before operation [（272.3±88.1）, （236.8±77.4）, （173.1±59.9） vs （318.5±148.6） ng/L, t= 2.173, P〈 0.05; t= 3.961, P〈 0.01; t= 7.464, P〈 0.01], respectively. Conclusion The VEGF was related to the onset and progression and metastasis of colon cancer. It has clinical significancy for diagnosis of colon cancer and judgment of curative effect and prognosis.