血管内皮生长因子在常见恶性肿瘤诊治中的临床价值  

Clinical value of vascular endothelial growth factor in the diagnosis and treatment of common malignant tumors

作　　者：江丰收[1] 孙玉蓓[1] 胡冰[1] 庄建生[1] 吕桦[2] 

机构地区：[1]安徽省立医院肿瘤科,安徽合肥230001 [2]安徽医科大学流行病与卫生统计学系,安徽合肥230032

出　　处：《中国癌症杂志》2005年第3期278-281,共4页China Oncology

摘　　要：目的:探讨血管内皮生长因子(VEGF)在常见恶性肿瘤诊断、治疗和预后中的临床意义。方法:应用酶联免疫吸附法(ELISA)检测544例恶性肿瘤患者及87例对照者血清中VEGF浓度和CEA、CA50等6种肿瘤标记物的水平。计算VEGF的灵敏度、特异度、阳性预测值和阴性预测值,分析患者治疗前血清VEGF水平对其近期疗效的影响以及VEGF和其他肿瘤标记物联合检测结果与患者疗效的关系。结果:①各种肿瘤患者血清VEGF平均水平均高于对照组,其中以胃癌、肝癌和肺癌患者较高;②VEGF以200.6(ng/L)为医学参考值上限,其灵敏度为54.2%,特异度为95.4%;有负荷组患者灵敏度可达到74.9%,而无负荷者仅为20.4%,其差别有统计学意义(P<0.01);③肿瘤患者随着血清VEGF平均水平的升高,其疗效逐渐降低(P<0.05)。五种肿瘤标记物联合分析显示,随着患者血清肿瘤标记物阳性数目的增多,无效患者的比例呈上升趋势,当患者血清肿瘤标记物阳性数目达到3种或以上时,约89%的患者显示无效。结论:血清VEGF是一种广谱的肿瘤标记物,对多种肿瘤的辅助诊断均有重要的临床价值,且对初诊肿瘤患者,VEGF是一个良好的检测指标,其鉴别诊断价值优于其他6种肿瘤标记物。VEGF与其他肿瘤标记物联合检测有助于临床疗效评价、预后评估和病情随访监测。Purpose:To explore the clinical significance of VEGF in the diagnosis, treatment and prognosis of common malignant tumors. Methods:The levels of serum VEGF were measured by sandwich enzyme linked immunosorbent assay (ELISA) in 544 patients with malignant tumors and 87 healthy subjects. At the same time,another 6 tumor markers including CEA and CA50 were measured by immunoradiometric assay (IRMA) in 544 malignant tumor patients. Sensitivity, specificity, positive predictive value and negative predictive value of VEGF detection were calculated respectively. The relationship between the pre-treatment levels of serum VEGF and their clinical effect, and between the positive expression number of five kinds tumor markers jointly and the therapeutic effect were analyzed respectively. Results:1. The serum VEGF levels in patients with all kinds of malignant tumors were higher than those of the controls, the mean serum VEGF were relatively higher in patients with gastric cancer, liver cancer and lung cancer. 2. According to the cutoff of medicine reference of VEGF (200.6ng/L), its sensitivity and specificity were 54.2% and 95.4% respectively. There was a significant difference between the sensitivity of serum VEGF in patients with tumor burden (74.9%) and that in patients without tumor burden (20.4%)(P<0.01). 3. With the rising of the serum VEGF level, the patient’s therapeutic effect gradually declined (P<0.05). The combined analysis suggested that with the increase of the positive number of serum tumor markers, the proportion of ineffective patients showed a growing trend. When the positive numbers of serum tumor markers reached 3 or more than 3, the treatment of about 89% patients showed ineffective. Conclusions:The serum VEGF is a broad-spectrum tumor marker, and is an important index in the diagnosis of different kinds of malignant tumors. VEGF is a good detection marker when the diagnosis of the patients was made for the first time, and its role in differential diagnosis is more important than that of the other 6 tu

关 键 词：肿瘤 血管内皮生长因子 肿瘤标记物 血清学诊断 CEA CA50 CA199 AFF 

分 类 号：R730.4[医药卫生—肿瘤] R730.7[医药卫生—临床医学]