检测腹水中血管内皮生长因子和Ⅳ型胶原酶对鉴别良恶性腹水的意义

An evaluation of detecting vascular endothelial growth factor and type IV collagenase in ascites

目的 检测腹水中血管内皮生长因子 (VEGF)和IV型胶原酶 ,为临床腹水定性诊断提供依据。方法 收集各种类型腹水 ,采用ELISA法检测VEGF含量 ,用明胶酶谱法检测IV型胶原酶活性。结果 恶性腹水中VEGF水平为 ( 64 0 .74± 2 64 .81)pg/ml ,明显高于肝硬化腹水和结核性腹水 (P值均 <0 .0 1)。肝硬化腹水和结核性腹水不能检出基质金属蛋白酶 2 , 9(MMP 2 , 9) ,而恶性腹水MMP 2检出率为 87.0 % ,MMP 9检出率为 78.3 % ,且MMP 2活性高于MMP 9活性 (P <0 .0 5 )。结论 恶性腹水VEGF水平显著升高且IV型胶原酶阳性。VEGF、IV型胶原酶对良、恶性腹水的鉴别诊断有重要价值 。

Objective To evaluate the significance of ascite VEGF levels and type IV collagenase activity in qualitative diagnosis of ascites.Methods Various kinds of ascites were harvested and VEGF levels were detected by enzyme-linked immunosorbent assay.Type IV collagenase activity was tested by gelatin zymography.Results VEGF levels in malignant ascites were 640.74 pg/ml±264.81 pg/ml,significantly higher than those in cirrhotic ascites and tuberculous ascites(P<0.01).The activities of matrix metalloproteinase-2 and matrix metalloproteinase-9 could not be detected in cirrhotic ascites and tuberculous ascites but could be detected in 20 and 18 of 23 malignant ascites,respectively.Furthermore,the activity of MMP-2 was higher than that of MMP-9(P<0.05).Conclusions VEGF levels increase extremely and type IV collagenase is positive in malignant ascites.The detections of VEGF and type IV collagenase are useful in differential diagnosis of benign and malignant ascites.They may play an important role in malignant ascites formation.