Elevated perioperative serum vascular endothelial growth factor levels in patients with colon carcinoma
Elevated perioperative serum vascular endothelial growth factor levels in patients with colon carcinoma
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DOI：
10.1002/cncr.11911
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发表时间：
2004-01-15
期刊：
影响因子：
6.2
通讯作者：
Galizia, G
中科院分区：
文献类型：
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作者：
De Vita, F;Orditura, M;Galizia, G
背景资料。据作者所知，迄今为止，对结肠癌手术患者血清中血管内皮生长因子(VEGF)水平的检测与预后的相关性尚不清楚。血管内皮生长因子是一种强有力的血管生成刺激因子。结果：结肠癌组术前血清血管内皮生长因子水平(平均值：504.1 pg/m l+/-223pg/m l；范围：285-1390pg/m l；95%可信区间[95%C l]，49 m g/m l)显著高于对照组(平均值：78.1pg/m l+/-22 p g/m l；范围：40-110pg/m l；95%C l，4.3p g/m l；P<；0.001)。多元回归分析显示，术前血清血管内皮生长因子水平与年龄(r=-0.275；P=0.013)、Dukes分期(r=0.488；P<；0.001)、癌胚抗原水平(r=0.285；P<；0.018)呈显著正相关。术前血清血管内皮生长因子水平与疾病部位、患者性别、肿瘤大小、肿瘤分级或功能状态之间没有明显的相关性。此外，接受根治性手术的患者术前血清血管内皮生长因子水平显著低于接受非根治性手术的患者(分别为443pg/ml+/-117pg/mlvs.821+/-353pg/ml；P<；0.0001)。Logistic回归分析显示，术前血清血管内皮生长因子和癌胚抗原水平是预测根治性和非根治性手术预后的唯一良好指标(P<；0.001；相对危险度分别为2.98和2.03)。此外，术后血清血管内皮生长因子水平明显下降，并有进一步下降趋势，直到术后第30天(P<；0.001)。逐步回归分析选择手术前血清血管内皮细胞生长因子水平作为唯一与疾病特异性生存和无病生存预测显著相关的变量(P=0.001)。结论：术前血清血管内皮生长因子水平可能有助于结肠癌手术患者预后的预测。(C)2003年美国癌症协会。
BACKGROUND. To the authors' knowledge, little is known to date regarding the prognostic relevance of measuring serum levels of vascular endothelial growth factor (VEGF), a potent stimulator of angiogenesis, in patients with colon carcinoma who undergo surgery.METHODS. Preoperative and postoperative VEGF serum levels were determined by enzyme-linked immunoadsorbent assay in 81 patients with colon carcinoma who were undergoing surgery. Fifty healthy individuals served to define normal VEGF serum levels.RESULTS. Preoperative VEGF serum levels were significantly higher in the group of patients with colon carcinoma (mean, 504.1 pg/mL +/- 223 pg/mL; range, 285-1390 pg/mL; 95% confidence interval [95%Cl], 49 pg/mL) compared with the control group (mean, 78.1 pg/mL +/- 22 pg/mL; range, 40-110 pg/mL; 95%Cl, 4.3 pg/mL; P < 0.001). Multiple regression analysis demonstrated a significant correlation (r) between preoperative VEGF serum levels and age (r = -0.275; P = 0.013), Dukes stage (r = 0.488; P < 0.001), and carcinoembryonic antigen (CEA) levels (r = 0.285; P < 0.018). No significant correlation was found between preoperative VEGF serum levels and disease site, patient gender, tumor size, tumor grade, or performance status. Moreover, preoperative VEGF serum levels were significantly lower in patients who underwent curative surgery compared with patients who underwent noncurative surgery (443 pg/mL +/- 117 pg/ml. vs. 821 +/- 353 pg/mL, respectively; P < 0.0001). Logistic regression analysis selected preoperative VEGF and CEA serum levels as the only good prognostic indicators of curative and noncurative surgery (P < 0.001; relative risk, 2.98 and 2.03, respectively). Furthermore, VEGF serum levels dropped significantly after surgery, with a further downward trend until the 30th postoperative day (P < 0.001). Stepwise regression analysis selected pieoperative VEGF serum level as the only variable associated significantly with the prediction of both disease-specific survival and disease-free survival (P = 0.001).CONCLUSIONS. Preoperative serum VEGF levels may be useful for predicting outcome in patients with colon carcinoma who undergo surgery. (C) 2003 American Cancer Society.