The Quantitative Analysis And Clinical Significance Of VEGF, BFGF, IGFBP-2 In Plasma And CSF Of Patient With Glioma

Objective:Glioma is common malignant tumor, which has strongly invasive power and recurrence fast.It is one of the most formidable of refractory tumors in neurosurgery. Early diagnosis and treatment are two important influential factors for the patients.To investigate the expression of VEGF, bFGF, IGFBP-2 in plasma and CSF of patient with glioma. and to evaluate their clinical significance.Gliomas are the most common intracranial tumor, showing invasive growth.The clinical prognosis is poor. The invasion process is a complex multi-step continuous process, involving adhesion molecules, enzymes, cytokines, gene regulation and many other factors. Insulin-like growth factor binding protein (IGFBP) is a high affinity IGF binding proteins, not only has the function of transport proteins, but also through IGF-dependent and non-dependent mechanism to inhibit or promote the role of IGF. IGFBP-2 in the high-level expression of glioma increased by IGF-dependent and IGF-independent mechanisms of action, and tumor prognosis, invasive and metastasis are closely linked. Vascular endothelial growth factor known as vascular permeability factor, is the in vivo cell growth of vascular endothelial growth-specific mitogen and vascular permeability factor. VEGF family members include VEGF2A, VEGF2B, VEGF2C, VEGF2D, VEGF2E, PIGF. New research shows that, VEGF occurs in the tissues and organs, have played an important role in the normal state of maintenance, a variety of tumors, development and transfer. The different biological functions of VEGF to be mediated by different receptors, has been found that four kinds of receptors.bFGF as a cell mitogen and pro-angiogenic factors can directly act on tumor cells secrete a variety of proteolytic enzymes and collagenase, thereby promoting tumor metastasis and invasion.In addition, The activities of tumor growth period is significantly promote the formation of tumor blood vessels and through the tumor capillary endothelial proliferation, increase tumor blood supply, promoting tumor cell division.Methods: General Information Specimens from the May 2008 ~ June 2009 2nd Affiliated Hospital of Hebei Medical University, Neurosurgery diagnosed patients, including WHOⅠ-Ⅳgrade glioma 40 cases, with an average age (34.6±6.8) years, and WHOⅠ-Ⅱfor low-level group, 18 cases; WHOⅢ-Ⅳfor high-level group, 22 cases. The normal control group, 10 cases, with an average age (37.7±10.2) years of age. Glioma patient before surgery, after 3 days, after 2 weeks again, blood and cerebrospinal fluid specimens, placed in -20℃refrigerator, batch testing VEGF, bFGF, IGFBP-2 concentrations. Patients were excluded merger systemic infections, heart, liver and lung disease, diabetes and other tumors.Patient blood samples collected 1 d before the normal diet, fasting evening after 12 o'clock, 7 o'clock the next day fasting blood through the radial vein 5ml, 1 h within the 3 500 r / min centrifugation 10 min, collection of plasma to 1.5 ml centrifuge tubes sub - loaded, -20℃to save, batch testing. all rows lumbar puncture cerebrospinal fluid collection, in order to 1.5ml centrifuge tube-packing, -20℃to save, batch testing.The expression of CSF and plasma VEGF, bFGF, IGFBP-2 were tested by ELISA in 40 cases of glioma(gradeⅠ7,gradeⅡ11, gradeⅢ14,gradeⅣ8) and 10 cases of healthy controls.Statistical methods: the use of statistical software SPSS13.0 processing, measurement data with the mean±standard deviation(?x±s), multiple comparisons using single-factor analysis of variance, paired t testResults: Plasma VEGF, bFGF, IGFBP-2 expression in high grade group were significantly higher than that in low grade group(p<0.001) and controls(p<0.001).There was no significant difference between low grade group and controls(p>0.05).CSF VEGF, bFGF, IGFBP-2 expression in high grade group were significantly higher than that in low grade group(p<0.001) and controls(p<0.001).There was no significant difference between low grade group and controls(p>0.05).The plasma VEGF, bFGF, IGFBP-2 level in high grade group increased after removal of tumor for 3days and decreased after removal of tumor for 14days.(p<0.05) The CSF VEGF, bFGF, IGFBP-2 level in high grade group increased after removal of tumor for 3days and decreased after removal of tumor for 14days. (p<0.05)Conclusion:1 High-grade gliomas plasma, CSF VEGF, bFGF, IGFBP-2 concentrations were significantly higher than that of low-grade gliomas group and normal. Low-grade gliomas plasma, CSF VEGF, bFGF, IGFBP-2 concentrations have no significant difference between normal, This suggests that these three factors are associated with malignant glioma2 High-grade gliomas preoperative plasma, CSF VEGF, bFGF, IGFBP-2 concentrations were significantly higher than normal.Concentration increased after 3 days to monitor more apparent. The concentration decreased significantly after 2 weeks. In view of research and time constraints,this experiment failed to glioma patients after long-term monitoring of serum and cerebrospinal fluid. To explore its relationship with tumor recurrence ,the next step could be the concentration of these three factors change after long-term monitoring.Dynamic detection of CSF and plasma VEGF, bFGF, IGFBP-2 level inpatients with glioma is helpful for judging disease condition.