上皮性卵巢癌中VEGF、sFlt1的表达及临床意义

目的:探讨血管内皮细胞生长因子(VEGF)及其可溶性受体sFlt1在上皮性卵巢肿瘤患者血清、腹水、瘤液中的表达及其临床意义。方法:采用ELISA法检测34例上皮性卵巢癌患者血清、腹水、瘤液中VEGF及sFlt1的表达。结果:1)卵巢癌组术前血清VEGF明显升高,早期已显著升高,其作为区别良恶性卵巢肿瘤的标志物,灵敏度为76.5%,特异度为75.0%,阳性预测值为75.4%,阴性预测值为76.1%。2)卵巢癌组术前血清sFlt1显著降低,VEGF/sFlt1比值较对照组增长近10倍。腹水、瘤液中VEGF及sFlt1均明显高于相应的血清水平。结论:卵巢癌患者处于严重的血管生成失衡状态。术前血清VEGF是较好的血清标志物,对早期卵巢癌的辅助诊断有一定价值;术后血清观察VEGF、sFlt1变化有利于进一步监测卵巢癌病情发展。

The Expression and Significance of VEGF and sFlt1 in Epithelial Ovarian Cancer

Objective: To study the expression and significance of VEGF and its soluble receptor sFlt1 in serum, ascitic fluids and tumor cysts from patients with epithelial ovarian cancer. Methods: ELISA was used to measure VEGF and sFlt1 in serum, ascitic fluids and tumor cysts from patients with ovarian cancer. Results: (1) VEGF levels were significantly elevated in the serum of cancer patients. Utilizing VEGF level as determined by ELISA as a marker for differentiating between benign and malignant ovarian tumors had a sensitivity of 76.5%, a specificity of 75%, a positive predictive value of 75.4%, and a negative predictive value of 76.1%. (2) In cancer patients, preoperative serum sFlt1 levels were significantly decreased, increasing the ratio of VEGF/sFlt1 10-fold. Higher VEGF and sFlt1 levels were detected in ascitic fluids and/or tumor cysts than in corresponding serum. Conclusions: The preoperative serum VEGF level was a promising marker for differentiating between benign and malignant tumors, especially useful in early diagnosis of ovarian cancer. The dramatic elevation of the VEGF/sFlt1 ratio in the group with cancer suggests significant physiological abnormalities in terms of angiogenesis. Observation of the change in postoperative serum VEGF and sFlt1 was helpful for monitoring progression of ovarian cancer.