卵巢恶性肿瘤患者测定血清血管内皮生长因子的临床价值

Study on serum vascular endothelial growth factor level in ovarian malignant tumors

目的 探讨血清血管内皮生长因子 (VEGF)测定对卵巢恶性肿瘤诊断、病程监测和预后的价值。方法 采用酶联免疫吸附法 (ELISA)对 90例健康妇女 (对照组 )、2 5例卵巢良性肿瘤 (良性组 )及 12 0例卵巢恶性肿瘤 (恶性组 )进行血清VEGF含量分析 ,并进一步对其中 2 5例卵巢恶性肿瘤患者进行手术治疗前后血清VEGF含量的动态观察。结果 ( 1)恶性组术前血清VEGF含量为 ( 766±12 3 7)mg/L ,显著高于良性组的 ( 5 6± 2 3 )mg/L及对照组的 ( 5 5± 19)mg/L(P =0 0 0 6) ,以 10 0mg/L为界值 ,其诊断的特异性为 87% ,敏感性为 77% ;( 2 )恶性组临床分期Ⅰ～Ⅱ期和高～中分化患者术前血清VEGF含量分别为 ( 198± 2 87)mg/L和 ( 2 80± 5 5 2 )mg/L ,明显低于临床分期Ⅲ～Ⅳ期的 ( 95 5±1716)mg/L和低分化患者的 ( 991± 13 49)mg/L (P <0 0 5 ) ;但血清VEGF含量与组织学类型无关 (P>0 0 5 ) ;( 3 )手术治疗后血清VEGF含量为 ( 118± 110 )mg/L ,较手术治疗前血清VEGF含量 [( 10 74±12 11)mg/L]明显下降 ;( 4)初治患者血清VEGF阳性者 (即VEGF≥ 10 0mg/L)平均总生存期为 2 8个月 ,而血清VEGF阴性者平均总生存期为 3 5个月 (P <0 0 5 )。但COX模型分析结果发现 ,VEGF不是与卵巢恶性肿瘤预后相关的独立因素

Objective To explore the diagnostic value of serum vascular endothelial growth factor (VEGF) level in patients with ovarian carcinomas, and to evaluate the correlation between serum VEGF level and prognosis of ovarian cancer. Method Serum VEGF level in patients with ovarian neoplasms (120 cases of ovarian carcinomas, 25 cases of benign tumors) and 90 healthy women as controls was determined by enzyme linked immunosorbent assay (ELISA), also the change of preoperative and postoperative serum VEGF level of 25 cases of epithelial ovarian cancer was observed. Results (1)The preoperative serum VEGF levels were (766±1 237) mg/L in malignant groups, and there was a significant difference compared with normal controls(55±19) mg/L or patients with benign tumor(56±23) mg/L (P<0.05). As a cut-off at 100 mg/L, sensitivity and specificity of preoperative serum VEGF levels for diagnosing ovarian cancer was 77% and 87% respectively.(2) Serum VEGF level were significantly elevated in advanced stage(955±1 716) mg/L and poorly differentiated (991± 1 349) mg/L compared with early stage(198±287) mg/L and well differentiated(280±552) mg/L(P<0.05) , but there is no significant difference between the VEGF level and pathological types (P>0.05). (3) The postoperative serum VEGF levels(118±110) mg/L were significantly lower than that in preoperative (1 074±1 211) mg/L. (4) The average total survival-time in patients with VEGF(+) was 28 months, but it in patients with VEGF(-) was 35 months (P<0.05). Conclusion Serum VEGF values were higher in malignant tumors and preoperative serum VEGF level has a potential as a marker for diagnosing and monitoring in ovarian neoplasms.