血清VEGF、CA19-9以及OPN水平检测对大肠癌的临床诊断和手术疗效价值

Perioperative Clinical Investigation of Serum VEGF, CA19-9 and OPN Levels in Patients with Colorectal Carcinoma

目的探讨大肠癌患者手术前后血清血管内皮生长因子(vascular endothelial growth factor,VEGF),糖蛋白抗原CA19-9(carbohydrate antigen 19-9,CA19-9)和骨桥蛋白(osteopontin,OPN)的含量变化及其临床意义.方法对50例大肠癌患者VEGF、CA19-9、OPN以及癌胚抗原(carcinoembryonicantigen,CEA)联合检测判断大肠癌阳性检出率,并测定术前、术后5 d和术后10 d血清血管内皮生长因子(VEGF)、糖蛋白抗原CA19-9以及骨桥素(OPN)的含量.结果 VEGF、CA19-9和OPN 3者联合检测时大肠癌检出率高于单独检测CEA.手术后5 d以及手术后10 d患者血清中VEGF、CA19-9以及OPN水平与术前相比有明显降低(P<0.05).大肠癌TNM I和II期患者血清中3种肿瘤标志物含量明显低于III和IV期患者(P<0.05);中-低分化(包括未分化)患者血清中VEGF、CA19-9以及OPN水平高于高分化患者,2组比较差异具有统计学意义(P<0.05).结论血清VEGF、CA19-9和OPN水平可作为大肠癌临床分期、判断预后和恶性程度的依据,3者可作为大肠癌诊断、分期、预后判断的重要指标,值得临床推广应用.

Objective To investigate the levels of serum VEGF, CA199 and OPN in the perioperative patients with colorectal carcinoma, and evaluate their clinical significance. Methods The levels of serum VEGF,CA19- 9 and OPN in 50 patients were determined by enzyme- linked immunosorbent assay（ELISA） preoperative and 5 days and 10 days of postoperative. Results The levels of VEGF, CA19- 9 and OPN in serum of patients with colorectal carcinoma were decreased dramatically after operation, and were significantly different when tested before, 5 days after and 10 days after operation（P〈0.05）. Patients with TNM Ⅰ/Ⅱ carcinoma had much lower levels of the three tumor markers in serum compared with those with TNM Ⅲ/Ⅳ carcinoma（P〈0.05）, while patients with poor- moderate differentiated carcinoma had much higher levels of the three tumor markers compared with those with well- moderate carcinoma（P〈0.05）. Conclusion Levels of serum VEGF,CA19- 9 and OPN are closely related to the metastasis of colorectal carcinoma. So, they can be used as tumor markers of colorectal carcinoma to help determining the stage and prognosis.