血管内皮生长因子在恶性腹水诊断及形成中的作用

Vascular endothelial growth factor in the diagnosis and formation of malignant ascites

目的 探讨血管内皮生长因子 (VEGF)对恶性腹水的诊断价值及其在恶性腹水形成中的作用。方法 收集各种类型腹水及腹腔液 ,采用ELISA法检测VEGF水平。结果 癌性腹水组VEGF水平为 (6 4 0 .7± 2 6 4 .8)pg/ml,明显高于肝硬变腹水组、结核性腹水组及良、恶性疾病不伴腹水患者腹腔液组 (P <0 .0 1) ,而后 4组间比较VEGF水平则无明显差异 (P >0 .0 5 )。不同组织来源恶性腹水中卵巢癌组VEGF水平为 (86 6 .3± 2 0 8.5 )pg/ml,高于胃癌组 (P <0 .0 1)和结肠癌组 (P <0 .0 1) ;胃癌组VEGF水平高于结肠癌组 ,但差异无显著性 (P >0 .0 5 )。以肝硬变腹水作为对照组 ,以其VEGF含量均值上限 118.96pg/ml为阳性界值时 ,诊断恶性腹水的敏感性为 91.3% ,特异性为 88.9%。结论 VEGF对良、恶性腹水的鉴别诊断有重要价值 ,它可能在恶性腹水的形成中起重要作用。

Objective To explore the diagnostic value of vascular endothelial growth factor(VEGF) in malignant ascites and the role in the formation of malignant ascites.Methods VEGF levels from various ascites and fluids of abdominal cavity were detected by enzyme-linked immunosorbent assay(ELISA).Results VEGF levels in malignant ascites were(640.7±264.8) pg/ml,significantly higher than those in cirrhotic ascites,tuberculous ascites,and fluids of abdominal cavity of patients with benign and malignant disease but without ascites(P<0.01).However,there was no remarkable difference in VEGF levels among the latter 4 groups(P>0.05).VEGF levels in malignant ascites from patients with ovarian cancers were (866.3±208.5)pg/ml, higher than those with gastric (P<0.01) and colon cancers(P<0.01),but there was no significant difference in VEGF levels between gastric and colon cancers(P>0.05).Using VEGF levels 118.96 pg/ml as a minimum cutofflimit,the sensitivity and specificity of VEGF of this assay to diagnose ascites were 91.3% and 88.9%,respectively.Conclusion The detection of VEGF levels is useful in differential diagnosis of benign and malignant ascites.VEGF may play an important role in malignant ascites formation.