Vascular endothelial growth factor and its receptor to diagnose lymph node metastasis in patients with oral cancer

目标。目的探讨血管内皮生长因子（VEGF）家族在口腔鳞状细胞癌（OSCC）患者中的临床应用价值。采用酶联免疫吸附法检测129例新鲜原发口腔SCCs患者术前血清VEGF家族（VEGF- a、-C、-D）及其受体（sVEGF-R1、sVEGF-R2）水平。探讨VEGF家族与临床病理参数、治疗反应及预后的关系。OSCC患者血清VEGF-A、-C和-D水平明显高于健康对照组，但sVEGF-R1和sVFGF-R2均无差异。与健康对照者血清VEGF家族滴度分布的95%范围比较，VEGF- a、-C和-D的阳性率分别为41%、31%和57%。血清VEGF-A水平与性别、肿瘤大小、分期有显著相关性。VEGF-C浓度与远处转移相关，与淋巴结转移无关。VEGF-C阳性组5年生存率明显低于VEGF-C阴性组（63.2% vs. 83.5%, p<0.05）。VEGF-D水平与淋巴结转移及侵袭方式呈负相关。此外，我们通过免疫组化检测了VEGF-C、Flt-4、CD34、CD31和D2-40在24例牙龈癌中的表达。VEGF-C和Flt-4的表达与淋巴结转移无关。免疫组化方法与血清学方法无相关性。血清VEGF-C水平可能作为OSCC的生物学标志物有潜在的应用价值，但需要通过更大规模的研究来证实免疫组织化学和血清学方法之间的关系

Objective. To evaluate the clinical usefulness of vascular endothelial growth factor (VEGF) family in patients with oral squamous cell carcinoma (OSCC).Methods. Preoperative serum values of VEGF family (VEGF-A,-C, and -D) and their receptor (sVEGF-R1,sVEGF-R2) were measured by enzyme-linked immunosorbent assay in 129 patients with fresh primary oral SCCs. The relationship among VEGF family, clinicopathological parameters, response to therapy and prognosis was investigated.Results. Serum VEGF-A,-C, and -D levels were significantly higher in patients with OSCC than in the healthy control, but both sVEGF-R1 and sVFGF-R2 were not. On the basis of comparision to the 95% range of distribution of serum VEGF family titers in healthy control subjects, the positivity rates of VEGF-A,-C and -D were 41, 31, and 57%, respectively. The serum level of VEGF-A correlated significantly with sex, tumor size and Stage. VEGF-C concentration correlated significantly with distant metastasis, but not with lymph node metastasis. The VEGF-C positive group showed a significantly lower 5-year survival rate than the VEGF-C negative group (63.2% vs. 83.5%, p<0.05). The level of VEGF-D negative correlated with lymph node metastasis and mode of invasion. Moreover, we examined expression of VEGF-C,Flt-4,CD34,CD31 and D2-40 for 24 gingival cancers by immunohistochemistry. Both expressions of VEGF-C and Flt-4 did not correlated with lymph node metastasis. There was no relationship between immunohistochemical and serological methods.Conclusion. The serum level of VEGF-C might have potential usefulness as biological marker of OSCC, but it is necessary to confirm relationship between immunohistochemical and serological methods by a larger scale study