检测恶性腹水中VEGF、CD44v6和MMP-2、MMP-9的临床意义  

Clinical Significance of Detecting VEGF, CD44v6, MMP-2, and MMP-9 in Malignant Ascites

作　　者：孙晓敏[1] 董卫国[1] 余保平[1] 罗和生[1] 于皆平[1] 

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《癌症》2004年第1期85-89,共5页Chinese Journal of Cancer

基　　金：湖北省自然科学基金资助项目(No.99J163)~~

摘　　要：背景及目的:恶性腹水中找到癌细胞有确诊意义,但阳性率很低。因此从腹水中寻找理想的癌性标记物已成为当前研究的主要课题。本课题拟通过检测腹水中血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)、细胞粘附分子CD44v6、基质金属蛋白酶-2,-9(matrixmetalloproteinase-2,-9,MMP-2,-9)的水平并进行分析,以期为临床腹水诊治提供科学依据。方法:收集肝硬化腹水36例、结核性腹水8例、恶性腹水23例。采用ELISA法检测VEGF、CD44v6含量,用明胶酶谱法检测MMP-2,-9活性。结果:恶性腹水中VEGF、CD44v6含量分别为(640.74±264.81)ng/L、(89.22±38.20)μg/L,明显高于肝硬化腹水犤(67.05±51.91)ng/L,(44.79±18.02)μg/L犦和结核性腹水犤(88.25±24.12)ng/L,(50.25±12.57)μg/L犦(P<0.01)。肝硬化腹水、结核性腹水不能检出MMP-2,-9,而恶性腹水MMP-2检出率为87.0%,MMP-9检出率为78.3%。结论:恶性腹水中VEGF、CD44v6水平显著升高而MMP-2,-9阳性。联合检测腹水中VEGF、CD44v6、MMP-2,-9的水平可作为临床良、恶性腹水的鉴别诊断依据之一。BACKGROUND &OBJECTIVE: Cytological examination, despite of its hig h specificity, has been found to have a low sensitivity in the diagnosis of mali gnant ascites due to the high percentage of false negative results. So it is ind ispensable to seek appropriate cancerous markers in ascites. The aim of this stu dy was to determine vascular endothelial growth factor (VEGF), CD44v6 levels and matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) acti vities in ascites so as to provide scientific basis for clinical diagnosis and t reatment of malignant ascites. METHODS: A total of 67 samples were collected, in cluding cirrhotic ascites (36), tuberculosis ascites (8), and malignant ascites (23). VEGF and CD44v6 levels were determined using enzyme-linked immunosorbent assay (ELASA). MMP-2 and MMP-9 activities were determined by gelatin zymograph y. RESULTS: VEGF and CD44v6 levels in malignant ascites were 640.74±264.81ng/L and 89.22±38.20μg/L, respectively, which were significantly higher than those in cirrhotic ascites (67.05±51.91ng/L, 44.79±18.02μg/L) and tuberculosis asci tes (88.25±24.12 ng/L, 50.25±12.57μg/L) (P< 0.01, respectively). The activiti es of MMP-2 and MMP-9 could not be detected in cirrhotic ascites and tuberculo sis ascites but could be detected in 20 and 18 out of 23 malignant ascites respe ctively. CONCLUSION: VEGF, CD44v6 levels increase significantly and MMP-2, MMP -9 activities are obvious in cancerous ascites. The detection of VEGF, CD44v6 l evels and MMP-2, MMP-9 activities are useful in differential diagnosis of beni gn and malignant ascites.

关 键 词：检测 恶性腹水 VEGF CD44V6 MMP-2 MMP-9 鉴别诊断 

分 类 号：R730.4[医药卫生—肿瘤]