血管内皮生长因子在分化型甲状腺癌中的表达及意义

Expression of serum vascular endothelial growth factor in differentiated thyroid cancer

目的观察血管内皮生长因子（vascular endothelial growth factor，VEGF）在分化型甲状腺癌（differentiated thyroid carcinoma，DTC）患者手术前后及复发时血清中的表达及其与血清甲状腺球蛋白（thyroglobulin，Tg）浓度之间的关系。方法采用酶联免疫吸附法（enzymelinked immunosorbentassay，ELISA）检测30例OTC（术后肺转移7例、局部复发23例）在术前、术后及复发时血清VEGF（serumVEGF，sVEGF）的水平及化学发光法检测血清Tg及TgA的浓度，并与30例正常对照组比较。结果肺转移组及局部复发组在手术前sVEGF比较差异无统计学意义（t=0．373，P〉0．05），与对照组比较差异有统计学意义（t值分别为8．597、14．140，P均〈0．05）；肺转移组及局部复发组在术后sVEGF明显降低，与术前比较差异有统计学意义（t值分别为5．977、11．500，P均〈0．05）；术后2组sVEGF与对照组比较差异均无统计学意义（t值分别为1．593、1．525，P均〉0．05）；肺转移组及局部复发组在复发前后sVEGF比较差异有统计学意义（t值分别7．387、12．160，P均〈0．05），复发后肺转移组sVEGF较局部复发组明显增高，差异亦有统计学意义（t=4．167，P〈0．05）。2组血清瞻浓度与sVEGF表达成直线正相关（r=0．786，P〈0．01）。结论sVEGF在DTC术前及术后复发患者血清中高表达，可作为评估DTC生物学行为的一项重要指标。

Objective To evaluate the expression of serum vascular endothelial growth factor（sVEGF） in differentiated thyroid carcinoma（DTC） patients before and after thyroidectomy and when recurrence occured. To analyze the relationship between serum VEGF and serum thyroglobulin（Tg）level. Methods sVEGF levels of 30 cases of DTC（7 patients with pulmonary metastasis, 23 patients with locoregional recurrence）were determined by enzyme-linked immunosorbent assay（ELISA） before and after thyroidectomy and when recurrence occured. The levels of serum Tg and thyroglobulin antibodies （TgA）were detected by chemiluminescence method. The results were compared with those of the 30 cases of normal controls. Results sVEGF levels had no significant difference between pulmonary metastasis group and locoregional recurrence group before operation （ t = 0. 373, P 〉 0.05 ）, but they were significantly higher than those in the normal control group（ t = 8. 597 and 14. 14 respectively, all P 〈 0. 05）. sVEGF levels in patients with pulmonary metastasis or locoregional recurrence were significantly reduced at the 3^rd week after operation and the difference had statistical significance with those before operation（ t = 5. 977, 11.50, P 〈 0. 05）. The difference of postoperative level of sVEGF in patients with pulmonary metastasis, locoregional recurrence and in patients of normal control group had no statistical significance （ t = 1. 593,1. 525, P 〉 0. 05）. sVEGF levels in patients with pulmonary metastasis or locoregional recurrence were significantly higher after recurrence than those before recurrence（ t = 7. 387, 12. 16 ,P 〈 0. 05）. After recurrence sVEGF levels in patients with pulmonary metastasis were significantly higher than those in patients with locoregional recurrence （t = 4. 167, P 〈 0. 05） It showed a positive linear correlation between serum Tg level and sVEGF level in DTC patients with recurrence（r =0. 786,P 〈0. 01 ）. Conclusion sVEGF is significantly elevated in DTC patients before operation and with postoperative recurrence, making it an important indicator to reveal the biological behaviors of DTC.