血管内皮生长因子（VEGF）提高了 CA125 对上皮性卵巢癌与卵巢囊肿的鉴别诊断能力。

Vascular endothelial growth factor (VEGF) improves the sensitivity of CA125 for differentiation of epithelial ovarian cancers from ovarian cysts.

机构信息

Department of Gynecology Oncology, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Arch Gynecol Obstet. 2013 Oct;288(4):859-65. doi: 10.1007/s00404-013-2819-7. Epub 2013 Apr 7.

DOI:10.1007/s00404-013-2819-7

PMID:23564055

Abstract

BACKGROUND

The present study aimed to compare the diagnostic value of preoperative serum levels of CA125 and vascular endothelial growth factor (VEGF), and the combination of both biomarkers for differentiating early stage epithelial ovarian cancers from ovarian cysts.

MATERIALS AND METHODS

In this study, preoperative and postoperative serum levels of CA125 and VEGF of 30 patients with epithelial ovarian cancers (cancer arm) compared with that of 30 patients with benign ovarian cysts (cyst arm). Initial eligibility included having an ovarian cystic or solid mass detected by transvaginal ultrasonography at the hospital clinic. Included patients had to have localized pelvic disease and no clinical or imaging evidence of extrapelvic disease, ascites and distant metastasis. Initial exclusion criteria included prior history of malignancy or any type of cancer treatment. After surgery, only patients with pathologic diagnosis of early stage epithelial ovarian cancer and ovarian cyst were included.

RESULTS

Preoperative serum levels of CA125 (P < 0.001) and VEGF (P < 0.001) were significantly higher in the study arm compared to the control arm. In addition, postoperative serum levels of CA125 (P < 0.001) and VEGF (P < 0.001) in study arm were significantly decreased compared to preoperative serum levels. At usual clinical cut-off levels of 17.6 pg/ml for VEGF and 35 U/ml for CA125, the sensitivity and specificity for detecting early stage epithelial ovary cancer were 90 and 57 % for VEGF and 66.6 and 73 % for CA125, respectively. At 100 % specificity for each test, the addition of VEGF to CA125 increased the sensitivity of early ovarian cancer detection from 60 to 73.3 %.

CONCLUSION

This study indicates that the addition of VEGF serum value improves the specificity and the sensitivity of CA125 to detect early stage epithelial ovarian cancers, and to differentiate these neoplasms from ovarian cyst.

摘要

背景

本研究旨在比较术前血清 CA125 和血管内皮生长因子（VEGF）水平及其联合检测对鉴别早期上皮性卵巢癌与卵巢囊肿的诊断价值。

材料与方法

本研究比较了 30 例上皮性卵巢癌患者（癌症组）和 30 例良性卵巢囊肿患者（囊肿组）术前和术后血清 CA125 和 VEGF 水平。最初的入选标准包括在医院门诊经阴道超声检查发现卵巢囊性或实性肿块。入选患者必须局限于盆腔疾病，无盆外疾病、腹水和远处转移的临床或影像学证据。最初的排除标准包括恶性肿瘤病史或任何类型的癌症治疗史。手术后，仅纳入病理诊断为早期上皮性卵巢癌和卵巢囊肿的患者。

结果

与对照组相比，研究组术前血清 CA125（P<0.001）和 VEGF（P<0.001）水平显著升高。此外，研究组术后血清 CA125（P<0.001）和 VEGF（P<0.001）水平较术前显著降低。在 VEGF 的常用临床截断值 17.6 pg/ml 和 CA125 的 35 U/ml 时，VEGF 和 CA125 检测早期上皮性卵巢癌的敏感性和特异性分别为 90%和 57%，66.6%和 73%。在每个检测的特异性为 100%时，VEGF 联合 CA125 可将早期卵巢癌检测的敏感性从 60%提高到 73.3%。