检测卵巢上皮性肿瘤患者血清和肿瘤组织中VEGF的临床意义

背景及目的:本研究拟通过对卵巢上皮性肿瘤患者血清血管内皮生长因子(vascularepithelialgrowthfactor,VEGF)水平的检测及对卵巢上皮性肿瘤组织中VEGF表达的观察,以探讨VEGF与卵巢上皮性肿瘤临床、病理诸因素的关系。方法:卵巢上皮性肿瘤患者73例,其中24例为良性肿瘤患者(良性组),7例为交界性上皮瘤患者(交界性组),42例为恶性肿瘤患者(恶性组);以同期在本科室查体无明显妇科疾患的20名妇女血清做对照。用免疫组化二步法检测73例卵巢上皮性肿瘤患者肿瘤组织中VEGF的表达,用ELISA法测定71例卵巢上皮性肿瘤患者术前血清及10例患者腹水中VEGF水平,对其中7例卵巢上皮性癌患者血清在术后进行了定期检测。结果:①VEGF在卵巢上皮性肿瘤组织中的表达,恶性组阳性表达率(86.36%)明显高于交界性组(66.67%,P<0.005)及良性组(37.50%,P<0.005)。②良性组、交界性组及恶性组之间血清VEGF水平的差异有统计学意义(P<0.01);在恶性组中,血清VEGF水平在临床Ⅲ、Ⅳ期明显高于Ⅰ、Ⅱ期(P<0.05),在病理分化差的G3组明显高于病理分化好的G1、G2组(P<0.01),而与病理类型相关性无统计学意义;卵巢癌患者经理想的肿瘤细胞减灭术后,血清VEGF水平均有不同程度下降,有3例患者病情复发后,血清VEGF水平再度上升。结论:①VEGF在卵巢上皮性肿

Serum level and expression of vascular epithelial growth factor in ovarian epithelial carcinoma

BACKGROUND & OBJECTIVE: This study was designed to examine the level of serum vascular epithelial growth factor (VEGF) and VEGF expression in the patients with ovarian epithelial carcinoma (EOC) and to evaluate the relationship between VEGF and the clinicopathological factors. METHODS: Seventy-three patients with ovarian epithelial tumor were selected as study group, including 24 benign epithelial ovarian tumor (BET), 7 borderline epithelial ovarian tumor (BOT), 42 EOC. Twenty women without obvious gynecologic diseases were selected as serum control group (CON). VEGF expression in the epithelial ovarian tumor tissues from 73 patients were analyzed immunohistochemically. Serum VEGF in 71 patients and ascite VEGF in 10 patients were detected by enzyme-linked immunosorbent assay (ELISA) and 7 cases with EOC were continuously determined after operation. RESULTS: (1) Positive immunostaining of VEGF was observed in 86.3% of EOC, which was significantly higher than that of BOT (66.67%, P < 0.005) and BET (37.5%, P < 0.005). (2) There were significant differences in serum VEGF level among BET, BOT, and EOC group (P < 0.01). Serum VEGF levels before operation in patients with EOC were significantly higher than those with BOT, BET, and CON (P < 0.01). Serum VEGF levels in EOC patients at advanced stage (stage III or IV), low differentiation (G3) were apparently higher than those at early stage (stage I or II) (P < 0.05) and high differentiation (G1, G2) (P < 0.01), respectively. Serum VEGF levels decreased after the successful removal of tumor in ovarian cancer patients. The serum VEGF levels were re-elevated during relapse in three patients. CONCLUSION: (1) The elevated serum VEGF levels and increased VEGF expression in EOC were associated with its maligment behavior. (2) Serum VEGF could be used as a marker for monitoring the clinical course of the patients with epithelial ovarian carcinoma.