Jiang Liejun, Hochwald Steven, Deng Shuang, Chen Yanyun, Tan Chunyan, Zhong Qiulian, Huang Huayi
Clin Lab. 2019 Jan 1;65(1). doi: 10.7754/Clin.Lab.2018.180552.
Biomarkers for early diagnosis and follow-up of cancers are still underutilized in clinical management. Thus, seeking new biomarkers with better sensitivity and specificity is still a challenge. VEGF, VEGFR2, and OPN are newly emerging biomarkers with clinical potential.
ELISA was used to analyze serum VEGF, VEGFR2, and OPN from 75 gastrointestinal cancer patients and 75 control subjects. The correlation of pre-operative serum VEGF, VEGFR2, and OPN levels with CEA, Ki-67 as well as clinical features (age, gender, tumor size, TNM stage, tumor stage, lymph node involvement, metastasis, and histological grading) in these patients.
The pre-operative and post-operative serum VEGF and VEGFR2 levels and the post-operative OPN level in patients were significantly higher than in controls (p = 0.000, for all mentioned). The post-operative VEGF and OPN levels were significantly higher than that of pre-operative (p = 0.000 and 0.007, respectively). There was no correlation between pre-operative serum VEGF, VEGFR2, and OPN levels and serum CEA concentration. The pre-operative serum VEGF level was significantly correlated with the tumor Ki-67 scores; however, there was no correlation between serum VEGFR2 and OPN and Ki-67 scores. Univariate logistic regression analysis revealed that serum VEGF level was significantly higher in patients with advanced TNM (III - IV) stage and with lymph node involvement than in patients with low TNM stage (I - II) and with no lymph node involvement. High OPN level was correlated with metastasis. Multivariate logistic regression analysis results showed that serum VEGF and VEGFR2 were the two most important factors for the diagnosis of gastrointestinal cancers in this study (p = 0.000, for both). Combinatorial analysis of the biomarkers improved the performance of the assays.
Serum VEGF and VEGFR2 are potential biomarkers for the diagnosis and prognosis evaluation of gastrointestinal cancers, while serum OPN is a potential biomarker for the prognostication of gastrointestinal cancers.
癌症早期诊断和随访的生物标志物在临床管理中仍未得到充分利用。因此，寻找具有更高敏感性和特异性的新型生物标志物仍然是一项挑战。血管内皮生长因子（VEGF）、血管内皮生长因子受体2（VEGFR2）和骨桥蛋白（OPN）是具有临床潜力的新兴生物标志物。
采用酶联免疫吸附测定（ELISA）法分析75例胃肠道癌患者和75例对照者血清中的VEGF、VEGFR2和OPN。分析这些患者术前血清VEGF、VEGFR2和OPN水平与癌胚抗原（CEA）、Ki-67以及临床特征（年龄、性别、肿瘤大小、TNM分期、肿瘤分期、淋巴结受累情况、转移情况和组织学分级）之间的相关性。
患者术前和术后血清VEGF和VEGFR2水平以及术后OPN水平均显著高于对照组（所有提及的比较，p = 0.000）。术后VEGF和OPN水平显著高于术前（分别为p = 0.000和0.007）。术前血清VEGF、VEGFR2和OPN水平与血清CEA浓度之间无相关性。术前血清VEGF水平与肿瘤Ki-67评分显著相关；然而，血清VEGFR2和OPN与Ki-67评分之间无相关性。单因素逻辑回归分析显示，TNM晚期（III - IV期）且有淋巴结受累患者的血清VEGF水平显著高于TNM低分期（I - II期）且无淋巴结受累患者。高OPN水平与转移相关。多因素逻辑回归分析结果显示，血清VEGF和VEGFR2是本研究中诊断胃肠道癌的两个最重要因素（两者p = 0.000）。生物标志物的组合分析提高了检测性能。
血清VEGF和VEGFR2是胃肠道癌诊断和预后评估的潜在生物标志物，而血清OPN是胃肠道癌预后的潜在生物标志物。
