结肠癌患者围手术期血清血管内皮生长因子水平升高。

Elevated perioperative serum vascular endothelial growth factor levels in patients with colon carcinoma.

作者信息

De Vita Ferdinando, Orditura Michele, Lieto Eva, Infusino Stefania, Morgillo Floriana, Martinelli Erika, Castellano Paolo, Romano Ciro, Ciardiello Fortunato, Catalano Giuseppe, Pignatelli Carlo, Galizia Gennaro

机构信息

Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, II Policlinico, Via S. Pansini 5, 90131 Naples, Italy.

出版信息

Cancer. 2004 Jan 15;100(2):270-8. doi: 10.1002/cncr.11911.

DOI:10.1002/cncr.11911

PMID:14716760

Abstract

BACKGROUND

To the authors' knowledge, little is known to date regarding the prognostic relevance of measuring serum levels of vascular endothelial growth factor (VEGF), a potent stimulator of angiogenesis, in patients with colon carcinoma who undergo surgery.

METHODS

Preoperative and postoperative VEGF serum levels were determined by enzyme-linked immunoadsorbent assay in 81 patients with colon carcinoma who were undergoing surgery. Fifty healthy individuals served to define normal VEGF serum levels.

RESULTS

Preoperative VEGF serum levels were significantly higher in the group of patients with colon carcinoma (mean, 504.1 pg/mL +/- 223 pg/mL; range, 285-1390 pg/mL; 95% confidence interval [95%CI], 49 pg/mL) compared with the control group (mean, 78.1 pg/mL +/- 22 pg/mL; range, 40-110 pg/mL; 95%CI, 4.3 pg/mL; P < 0.001). Multiple regression analysis demonstrated a significant correlation (r) between preoperative VEGF serum levels and age (r = - 0.275; P = 0.013), Dukes stage (r = 0.488; P < 0.001), and carcinoembryonic antigen (CEA) levels (r = 0.285; P < 0.018). No significant correlation was found between preoperative VEGF serum levels and disease site, patient gender, tumor size, tumor grade, or performance status. Moreover, preoperative VEGF serum levels were significantly lower in patients who underwent curative surgery compared with patients who underwent noncurative surgery (443 pg/mL +/- 117 pg/mL vs. 821 +/- 353 pg/mL, respectively; P < 0.0001). Logistic regression analysis selected preoperative VEGF and CEA serum levels as the only good prognostic indicators of curative and noncurative surgery (P < 0.001; relative risk, 2.98 and 2.03, respectively). Furthermore, VEGF serum levels dropped significantly after surgery, with a further downward trend until the 30th postoperative day (P < 0.001). Stepwise regression analysis selected preoperative VEGF serum level as the only variable associated significantly with the prediction of both disease-specific survival and disease-free survival (P = 0.001).

CONCLUSIONS

Preoperative serum VEGF levels may be useful for predicting outcome in patients with colon carcinoma who undergo surgery.

摘要

背景

据作者所知，迄今为止，关于在接受手术的结肠癌患者中测量血管内皮生长因子（VEGF，一种强大的血管生成刺激因子）血清水平的预后相关性知之甚少。

方法

采用酶联免疫吸附测定法测定81例接受手术的结肠癌患者术前和术后的VEGF血清水平。50名健康个体用于确定正常的VEGF血清水平。

结果

与对照组相比，结肠癌患者组术前VEGF血清水平显著更高（平均值，504.1 pg/mL±223 pg/mL；范围，285 - 1390 pg/mL；95%置信区间[95%CI]，49 pg/mL）（对照组平均值，78.1 pg/mL±22 pg/mL；范围，40 - 110 pg/mL；95%CI，4.3 pg/mL；P < 0.001）。多元回归分析显示术前VEGF血清水平与年龄（r = - 0.275；P = 0.013）、Dukes分期（r = 0.488；P < 0.001）和癌胚抗原（CEA）水平（r = 0.285；P < 0.018）之间存在显著相关性。术前VEGF血清水平与疾病部位、患者性别、肿瘤大小、肿瘤分级或体能状态之间未发现显著相关性。此外，与接受非根治性手术的患者相比，接受根治性手术的患者术前VEGF血清水平显著更低（分别为443 pg/mL±117 pg/mL和821±353 pg/mL；P < 0.0001）。逻辑回归分析选择术前VEGF和CEA血清水平作为根治性和非根治性手术仅有的良好预后指标（P < 0.001；相对风险分别为2.98和2.03）。此外，术后VEGF血清水平显著下降，直至术后第30天呈进一步下降趋势（P < 0.001）。逐步回归分析选择术前VEGF血清水平作为与疾病特异性生存和无病生存预测均显著相关的唯一变量（P = 0.001）。