Saarelainen Sami K, Staff Synnöve, Peltonen Nina, Lehtimäki Terho, Isola Jorma, Kujala Paula M, Vuento Maarit H, Mäenpää Johanna U
Department of Obstetrics and Gynecology, Tampere University Hospital, P.O. Box 2000, FI-33521, Tampere, Finland,
Tumour Biol. 2014 May;35(5):4651-7. doi: 10.1007/s13277-014-1609-6. Epub 2014 Jan 14.
Preoperative evaluation of the risk for metastases in endometrial carcinoma is challenging. The growth of new vessels, angiogenesis, is important for tumor growth and purported to be involved in the metastatic process. The aim of this study was to evaluate the significance of preoperative serum levels and immunohistochemical expression of angiogenic markers in predicting a metastasized disease. Preoperative sera from 98 consecutive women presenting with endometrial carcinoma were collected. Serum concentrations of VEGF, sFLT1, and CD105 were assessed by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry was used to assess the expression of CD105, VEGF, FLT1, and KDR. The results were correlated to the presence of metastases, presence of deep (≥50%) myometrial invasion, and the histological grade of the tumor. Tumors with other than endometrioid histology were excluded. Of the 80 evaluable patients, 11 had a metastasized disease. The serum concentration of VEGF was higher in the group with metastases than in the group without metastases (median [range], 743 pg/mL [546-1,183 pg/mL] vs. 383 pg/mL [31-1,524 pg/mL], p < 0.001, respectively). In the multivariable analysis, the concentration of VEGF was the sole independent, albeit weak predictive factor for the presence of metastases (odds ratio, 1.004, 95% confidence interval, 1.002-1.007; p = 0.001). The immunohistochemical expression of the markers was not associated with any of the clinicopathological features of the tumors. The results of the present study suggest that preoperative serum VEGF concentration correlates with the presence of metastases in endometrioid endometrial carcinoma.
子宫内膜癌转移风险的术前评估具有挑战性。新生血管的生长，即血管生成，对肿瘤生长很重要，并且据称参与了转移过程。本研究的目的是评估血管生成标志物的术前血清水平和免疫组化表达在预测转移性疾病中的意义。收集了98例连续就诊的子宫内膜癌女性患者的术前血清。通过酶联免疫吸附测定（ELISA）评估血清中VEGF、sFLT1和CD105的浓度。采用免疫组化法评估CD105、VEGF、FLT1和KDR的表达。将结果与转移情况、深肌层浸润（≥50%）情况以及肿瘤组织学分级相关联。排除非子宫内膜样组织学类型的肿瘤。在80例可评估患者中，11例有转移疾病。转移组的VEGF血清浓度高于无转移组（中位数[范围]，分别为743 pg/mL[546 - 1,183 pg/mL]和383 pg/mL[31 - 1,524 pg/mL]，p < 0.001）。在多变量分析中，VEGF浓度是转移存在的唯一独立预测因素，尽管预测能力较弱（优势比，1.004，95%置信区间，1.002 - 1.007；p = 0.001）。标志物的免疫组化表达与肿瘤的任何临床病理特征均无关联。本研究结果表明，术前血清VEGF浓度与子宫内膜样子宫内膜癌的转移情况相关。
