大肠癌中VEGF-C分泌水平的检测及其意义

目的 检测大肠癌患者血清及不同的细胞系中血管内皮生长因子C（VEGF-C）和血管生长因子（VEGF）的分泌水平，评估其在诊断大肠癌淋巴结转移中的意义。方法 采用酶联免疫法检测66例大肠癌（观察组）和30例健康者（对照组）血清中及4株大肠癌细胞系培养液中VEGF-C和VEGF的分泌的水平。结果 观察组血清VEGF-C和VEGF均高于对照组（P〈0．01）；有淋巴结转移组的血清VEGF-C和VEGF均高于无淋巴结转移组（P〈0．01）；有淋巴管和／或血管浸润组上述两指标均高于无浸润组（P〈0．01）。血清VEGF-C水平在1438．0pg／mL以上者其灵敏度为81．0％。特异性为76．0％；血清VEGF水平在240．2pg／mL以上者其灵敏度为72．0％，特异性为74．0％。联合检测VEGF-C和VEGF对淋巴结转移阳性率的预测价值达84．6％，阴性预测价值达94．4％，精确度达93．7％。LoVo及LOVo-5FU培养液中VEGF-C分泌水平明显升高（P〈0．01）。结论 检测VEGF-C为判断大肠癌患者淋巴结是否转移可能提供新的诊断依据。VEGF-C可望成为治疗大肠癌淋巴道转移的新靶点。

Serum vascular endothelial growth factor-C level in patients with colorectal carcinoma and its clinical significance

Objective To measure circulating vascular endothelial growth factor-C(VEGF-C) levels in(patients) with colorectal carcinoma,and assess the clinical significance in diagnosis of lymph node metastasis.Methods Sixty-six patients with colorectal carcinoma and 30 healthy control patients were included in this study.Circulating VEGF-C and VEGF levels were assessed by enzyme-linked immunosorbent assay.Results Serum VEGF-C and VEGF concentration was higher in patients with colorectal carcinoma than in healthy control patients(P<0.01).Patients with lymph node metastasis revealed higher serum VEGF-C and VEGF concentrations than those without hymph node metastasis(P<0.01).The level of VEGF-C and VEGF in lymphatic vessel invasion and venous invasion was higher in the group with invasion than in the group without invasion(P<0.01).Serum VEGF-C levels reached a sensitivity of 81.0% and a specificity of 76.0% with a cutoff value of 1438.0 pg/mL,whereas VEGF levels reached 72.0% sensitivity and(74.0)% specificity at 240.2 pg/mL.With combined determination of VEGF-C and VEGF levels,the(positive) predictive value was 84.6%,the negative predictive value was 94.6%,and accuracy was(93.7)%.Conclusions Circulating VEGF-C levels may provide additional information for distinguishing(between) the absence or presence of lymph node metastasis in patients with colorectal carcinoma.VEGF-C can become a new target spot in the treatment of lymphatic metastasis in patients with colorectal cancer.