结直肠癌患者血清血管内皮生长因子及白介素-35的水平及临床意义

Levels and clinical significance of serum vascular endothelial growth factor and interleukin-35 in patients with colorectal cancer

目的探讨结直肠癌患者血清中血管内皮生长因子(VEGF)及白介素(IL)-35的水平及与临床病理因素的关系。方法收集2016年1月至6月60例结直肠癌患者(观察组),及体检中心同期体检健康成年人60例(对照组)。应用酶联免疫吸附测定法(ELISA法)测定血清VEGF及IL-35水平并分析其与结直肠癌临床分期(TNM分期、Dukes分期)及临床病理特征的关系。结果观察组血清VEGF及IL-35水平明显高于对照组(P均<0.01)。血清VEGF水平在不同TNM分期、Dukes分期及不同组织分化程度的结直肠癌患者中差异具有统计学意义(P均<0.01),血清IL-35水平在不同TNM分期、Dukes分期结直肠癌患者中具有统计学差异(P均<0.01)。Pearson相关性分析显示结直肠癌患者血清VEGF与IL-35的表达水平呈正相关(r=0.629,P<0.05)。VEGF筛查结直肠癌的敏感度为68.33%,特异度为88.33%,且VEGF筛查结直肠癌结果与病理组织学检测诊断具有较高一致性(Kappa值=0.567)。结论结直肠癌患者血清VEGF及IL-35水平升高,并与临床分期相关,且VEGF与病理分化程度相关,可作为结直肠癌患者病情评估及预后判断的辅助指标。VEGF在结直肠癌筛查中具有较高敏感度及特异度,是一个重要的辅助诊断指标。

Objective To investigate the levels of serum vascular endothelial growth factor（ VEGF） and interleukin-35（ IL-35） in patients with colorectal cancer and the association with clinicopathological factors. Methods Sixty patients with colorectal cancer between January 2016 and June 2016 were selected as observation group,and 60 medically examined healthy adults at the same time were selected as control group. Enzyme-linked immunosorbent assay（ ELISA） was used to detect serum VEGF and IL-35 levels,and their associations with clinical stage（ TNM stage,Dukes stage） and clinicopathological features of tumor were analyzed. Results Serum VEGF and IL-35 levels in observation group were significantly higher than those in control group（ all P 0. 01）. There were significant differences in serum VEGF levels for colorectal cancer patients with different TNM stages,Dukes stages and different tissue differentiation degrees（ all P 0. 01）,and there were significant differences in serum IL-35 levels for colorectal cancer patients with different TNM stages and Dukes stages（ all P 0. 01）. Pearson correlation analysis showed that serum VEGF level was positively correlated with serum IL-35 level in colorectal cancer patients（ r = 0. 629,P 0. 05）. The sensibility of VEGF for screening colorectal cancer was 68. 33%,and the specificity for screening colorectal cancer was 88. 33%. The diagnosis of VEGF screening was in higher accordance with the diagnosis of histopathological examination（ Kappa = 0. 567）. Conclusions Serum VEGF and IL-35 levels rises in patients with colorectal cancer,and they are related to clinical staging in which VEGF is also related to pathological differentiation degree. They may be served as the auxiliary markers for evaluating severity of the disease and estimating prognosis. VEGF has higher sensitivity and specificity in screening colorectal cancer,so it may be served as an important auxiliary diagnosis marker.