Karayiannakis Anastasios J, Syrigos Konstantinos N, Zbar Andrew, Baibas Nicolaos, Polychronidis Alexandros, Simopoulos Constantinos, Karatzas Gabriel
Second Department of Surgery, Democritus University of Thrace, Medical School, Alexandroupolis, Greece.
Surgery. 2002 May;131(5):548-55. doi: 10.1067/msy.2002.123011.
Vascular endothelial growth factor (VEGF) is an angiogenic cytokine involved in the progression of solid tumors. In this study we evaluated the clinical usefulness of preoperative serum VEGF concentrations in patients with colorectal cancer. The changes in serum VEGF levels after tumor surgery were also evaluated.
Serum VEGF levels were determined by an enzyme-linked immunosorbent assay in the sera of 61 healthy control subjects and 67 patients with colorectal cancer preoperatively and 7 and 30 days after surgery.
Serum VEGF levels in patients with colorectal cancer (median, 492 pg/mL; interquartile range, 281 to 737 pg/mL) were higher (P <.0001) than in control subjects (median, 186 pg/mL; interquartile range, 100 to 273 pg/mL). There was a significant association between serum VEGF levels and disease stage, invasion depth of the tumor, the presence of lymph node and distant metastases, and the degree of differentiation. Curative but not palliative resection of the primary tumor resulted in a significant decrease of preoperative serum VEGF levels but normalized in only 72% of patients. Failure of a return of VEGF to normal after resection for cure was associated with an increased although not statistically significant risk of metastasis during follow-up. Univariate analysis showed a lower survival rate for patients with increased preoperative serum VEGF levels (P <.002). Multivariate regression analysis showed that the prognostic value of serum VEGF level was not independent of tumor stage.
These findings suggest that VEGF plays an important role in tumor progression and the formation of distant metastases in colorectal cancer. It is at present unclear whether serial estimation of serum VEGF is clinically useful in the prediction of tumor relapse.
血管内皮生长因子（VEGF）是一种参与实体瘤进展的血管生成细胞因子。在本研究中，我们评估了术前血清VEGF浓度在结直肠癌患者中的临床实用性。还评估了肿瘤手术后血清VEGF水平的变化。
采用酶联免疫吸附测定法测定61名健康对照者和67名结直肠癌患者术前、术后7天和30天血清中的VEGF水平。
结直肠癌患者血清VEGF水平（中位数为492 pg/mL；四分位间距为281至737 pg/mL）高于（P <.0001）对照者（中位数为186 pg/mL；四分位间距为100至273 pg/mL）。血清VEGF水平与疾病分期、肿瘤浸润深度、淋巴结及远处转移的存在以及分化程度之间存在显著关联。对原发性肿瘤进行根治性而非姑息性切除导致术前血清VEGF水平显著降低，但仅72%的患者恢复正常。根治性切除后VEGF未能恢复正常与随访期间转移风险增加相关，尽管差异无统计学意义。单因素分析显示术前血清VEGF水平升高的患者生存率较低（P <.002）。多因素回归分析显示血清VEGF水平的预后价值并非独立于肿瘤分期。
这些发现表明VEGF在结直肠癌的肿瘤进展和远处转移形成中起重要作用。目前尚不清楚血清VEGF的系列评估在预测肿瘤复发方面是否具有临床实用性。
