血清血管内皮生长因子在孤立性肺结节鉴别诊断中的价值

Value of serum-vascular endothelial growth factor in the differential diagnosis of solitary pulmonary nodule

目的 检测血清血管内皮生长因子 (S VEGF)水平 ,探讨肺部孤立性结节良恶性的鉴别诊断价值。方法 采用酶联免疫吸附法 (ELISA)对 6 8例孤立性肺结节患者和 2 0例健康人的S VEGF进行测定 ,观察恶性结节 (肺癌组 )、良性结节和健康人之间S VEGF水平的差异。 6 8名患者均于术后获得病理诊断。结果 健康人S VEGF水平的中位数为 4 2 .5 (10～ 170 )pg/ml,良性结节为 4 4 .0 (18～36 0 )pg/ml,肺癌为 75 .0 (18～ 890 )pg/ml。肺癌组与健康对照组的S VEGF水平差异有显著性 (P <0 .0 1) ;与良性结节组的差异亦有显著性 (P <0 .0 5 ) ;而良性结节组与健康对照组的S VEGF水平差异无显著性 (P >0 .0 5 )。腺癌和鳞癌患者的S VEGF水平差异无显著性 (P >0 .0 5 )。结论 在孤立性肺结节患者中 ,肺癌患者的S VEGF水平明显高于良性结节患者和健康人 ,高水平 (>10 0pg/ml)的S VEGF提示病灶为肺癌的可能性大 ,可考虑手术治疗。

Objective To evaluate serum vascular endothelial growth factor(S VEGF) in the differentiation of solitary pulmonary nodule(SPN). Methods Serum level of VEGF of 68 patients with SPN was measured by ELISA kit, and compared with the control group of 20 normal subjects. The nodules were diagnosed by operation and pathology. Results The median level of S VEGF was 42.5(range from 10 to 170)pg/ml in the control, 44(range from 18 to 360)pg/ml in benign nodule group and 75(range from 18 to 890)pg/ml in lung cancer group, with significant difference observed between the nodule group and control ( P <0.01), and between the lung cancer group and the benign nodule group( P <0.05), but not between the benign nodule group and the control. In addition, when S VEGF in different pathologic types of the limited number of lung cancer patients were compared, no significant difference was observed. Conclusion S VEGF is valuable in the differential diagnosis of solitary pulmonary nodule. An elevated S VEGF level ≥100 pg/ml in patients with SPN may strongly speak for a malignant nodule. Operation is suggested.