Prognostic significance of serum vascular endothelial growth factor and endostatin in patients with hepatocellular carcinoma
Prognostic significance of serum vascular endothelial growth factor and endostatin in patients with hepatocellular carcinoma
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DOI：
10.1002/bjs.4594
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发表时间：
2004-10-01
影响因子：
9.6
通讯作者：
Fan, ST
中科院分区：
文献类型：
--
作者：
Poon, RTP;Ho, JWY;Fan, ST
背景：血管内皮生长因子(VEGF)和内皮抑素分别促进和抑制血管生成。最近的研究表明，血清血管内皮生长因子和内皮抑素水平在不同类型癌症患者中的预后价值。方法：采用酶免疫分析法检测108例肝细胞癌患者手术前和20例健康对照血清中血管内皮生长因子和内皮抑素的水平。结果：肝细胞癌患者血清中的血管内皮生长因子水平明显高于对照组，而两组患者血清中的内皮抑素水平无明显差异。高水平的血清血管内皮生长因子，而不是内皮抑素，与静脉侵犯和晚期肿瘤显著相关。血清血管内皮生长因子水平高于中位数(>245.0 pg/ml)的患者总体生存率和无瘤生存率明显低于血清血管内皮生长因子水平低于中位数(P=0.012和P=0.022)的患者。在多因素分析中，血清血管内皮生长因子水平是一个独立的预后因素(危险比1.86(95%可信区间1.10~3.92)；P=0.032)。血清内皮抑素水平对总体或无瘤生存没有显著的预后影响。结论：血清中高水平的血管内皮生长因子是肝细胞癌切除术后不良预后的预测指标。血清血管内皮生长因子，而不是内皮抑素，可能是预测肝癌患者预后的有用标记物。
Background: Vascular endothelial growth factor (VEGF) and endostatin stimulate and inhibit turnout angiogenesis respectively. Recent studies have demonstrated the prognostic value of serum levels of both VEGF and endostatin in patients with various types of cancer. Their significance in patients with hepatocellular carcinoma (HCC) remains unclear.Methods: Serum VEGF and endostatin levels were measured by enzyme immumoassay in 108 patients with HCC before surgical resection and in 20 healthy controls. Preoperative serum VEGF and endostatin levels were correlated with clinicopathological features and long-term survival.Results: Serum VEGF levels in patients with HCC were significantly higher than those in controls, but serum levels of endostatin were similar in the two groups. High serum levels of VEGF, but not endostatin, were significantly associated with venous invasion and advanced tumour stage. Patients with a serum VEGF level higher than median (over 245.0 pg/ml) had significantly worse overall and disease-free survival than those with a lower level (P = 0.012 and P = 0.022 respectively). On multivariate analysis, serum VEGF level was an independent prognostic factor (hazard ratio 1.86 (95 per cent confidence interval 1.10 to 3.92); P = 0.032). Serum endostatin levels did not have significant prognostic influence on overall or disease-free survival.Conclusion: A high serum level of VEGF is a predictor of poor outcome after resection of HCC. Serum VEGF, but not endostatin, may be a useful prognostic marker in patients with HCC.