Vascular endothelial growth factor as prognostic factor in renal cell carcinoma
Vascular endothelial growth factor as prognostic factor in renal cell carcinoma
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DOI：
10.1016/s0022-5347(05)68049-4
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发表时间：
2000-01-01
影响因子：
6.6
通讯作者：
Ljungberg, S
中科院分区：
文献类型：
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作者：
Jacobsen, J;Rasmuson, T;Ljungberg, S
目的：血管内皮生长因子（Vascular endothelial growth factor， VEGF）已被认为是实体瘤血管化和生长的重要组成部分。评估肾细胞癌（RCC）患者血清VEGF水平，并将其与临床病理表现和临床结局相关。材料与方法：对164例肾细胞癌患者术前进行血清采集。采用定量ELISA法检测血清中VEGF（165）蛋白水平。进行单因素和多因素分析。结果：与对照组（中位数103.8 pg./ml）相比，RCC患者血清中VEGF（165）水平（中位数343.4 pg./ml）显著升高（p = 0.0001）。血清VEGF（165）水平与临床分期及组织病理分级相关。VEGF（165）水平低于中位数的患者的生存时间明显长于VEGF水平较高的患者（p = 0.0001）。单因素Cox回归分析VEGF（165）时也显示了这一点（p = 0.0001）。VEGF（165）对生存的影响在伴有静脉浸润的肿瘤患者（pT3b-c NO MO）和临床I - III期患者中尤为明显（p = 0.0240和p = 0.0023）。当使用多变量分析时，只有肿瘤分期和分级仍然是独立的预后变量。结论：RCC患者血清VEGF（165）水平与肿瘤分期、分级有显著相关性。升高的水平与不良生存相关。虽然在多变量分析中，VEGF并不是一个独立的预后因素，但血清中VEGF（165）的水平被发现有助于识别潜在进展性疾病的患者，特别是那些有静脉侵犯的患者。
Purpose: Vascular endothelial growth factor (VEGF) has been recognized as an important constituent of vascularization and growth of solid tumors. Serum VEGF levels were evaluated and correlated to clinicopathologic findings and clinical outcome in patients with renal cell carcinoma (RCC).Materials and Methods: Serum samples were collected before surgery in 164 patients with RCC. Levels of VEGF(165) protein in sera were measured using a quantitative ELISA. Univariate and multivariate analyses were performed.Results: The VEGF(165) level in serum was significantly increased (p = 0.0001) in patients with RCC (median 343.4 pg./ml.) compared with the control patients (median 103.8 pg./ml.). The level of VEGF(165) in serum correlated to clinical stage nd histopathological grade. Patients with VEGF(165) levels below median value had significantly longer survival time than patients with higher levels (p = 0.0001). This was also shown when VEGF(165) was analyzed in univariate Cox regression (p = 0.0001). The impact of VEGF(165) on survival was especially shown in patients having tumors with vein invasion (pT3b-c NO MO) and in patients with clinical stages I - III (p = 0.0240 and p = 0.0023, respectively). When using multivariate analysis, only tumor stage and grade remained as independent prognostic variables.Conclusions: In RCC, serum VEGF(165) level was significantly correlated to tumor stage and grade. Increased levels were correlated to adverse survival. Although, VEGF did not remain as an independent prognostic factor in multivariate analysis the levels of VEGF(165) in serum was found useful for the identification of patients with potentially progressive disease especially for those with vein invasion.