Change And Significance In Vascular Endothelial Growth Factor Level In Serum,Urine And Tissue Of Bladder Transitional Cell Carcinoma

Objective: Bladder transitional cell carcinoma is common tumor urology. The morbidity of bladder transitional cell carcinoma is the second in the word and the first of urology in our country. The main characters of pathology are a high risk of recurrence and multiplicate growth, which result in the great financial consumption and severe individual depression. Finding an ideal biological marker and evaluate the prognosis of bladder transitional cell carcinoma, which is the urologist's crucial duty. The same as other tumors, growth and metastasis of bladder transitional cell carcinoma are decided by Angiogenesis. The reason is that new tumor's cells acquire nourishment and metastasis by new vascular. Angiogenesis is adjusted by many factors, vascular endothelial grow factor (VEGF) is the most important among them. VEGF was first identified 1989 as a highly specific promoter of endothelial cell proliferation and migration in bovine pituitary cells. It exists in four forms, 121, 165, 189 and 206 amino acids in length and binds to three cell membrane receptors, Flt-1, Flt-1/KDR and Flt-4. VEGF is a potent endothelial cell mitogen. In culturedendothelial cells, VEGF can activate phospholipase and induce rapid increases of free cytosolic Ca++, VEGF has been shown to stimulate. Von will ebrand factor release from endothelial cells and induce expression of tissue factor activity in endothelial cells as well as in monocytes. VEGF has also been shown to be chemotactic for monocytes and osteoblasts. VEGF can induce angiogenesis as well as increase microvascular permeability. As a vascular permeability factor, VEGF acts directly on the endothelium and does not degranulate mast cells. It promotes extravastion of plasma fisrinogen leading to fibrin deposition which alter the tumor extracellular matrix subsequently promotes the migration of macrophages, fibroblasts and endothelial cells. Base on it. VEGF play important roles in growth and metastasis of solid tumors. In order investigate the role of VEGF in bladder transitional cell carcinoma. We determine the serum and urine vascular endothelial growth factor (VEGF) level in patients with bladder transitional cell carcinoma and to evaluate their significant of preoperative VEGF levels.Methods: This study comprised 30 patients with bladder transitional cell carcinoma from November 2001 to Mary 2002 in our urology impatient, including 26 men and 4 women 33 to 78 years old (mean age 61.1). Tumor staging was performed according to the TNM stage classification system of the 30 patients 19 had stage T1, 5 had stage T2 and6 had stage T3. Tumors were evaluated by the WHO classification as grades 1 to 3 in 7, 16 and 7 cases. We also analyzed samples from 15 male and 7 female controls with a benign urology condition and normal controls 28 to 77 years old (mean 54.0). Morning mid stream urinary and serum samples were collected preoperatively. Serum samples were obtained before endoscopic resection. Venous blood was collected. All of samples centrifuged at 3000 rpm for 10 minutes and stored at -30 ℃ until used to determine vascular endothelial growth factor. Immunhistochemical testing for expression VEGF was carried in 30 cases of bladder transitional cell carcinoma and the results were analyzed semi-quantitatively with the pathological image analysis system. The experimental date was demonstrated in x ± standard deviation. The analysis of variance and t test were used to the significance test and the relation about the date was measured with linear correlation by spss 10.0, statistic software.Results: The serum and urinary VEGF levels (x ± s) in bladder transitional cell carcinoma patients were (166.07±50.74) ng/l, (250.07 ± 42.99) ng/l, which were significantly higher than those of healthy subjects (63.59 ± 14.41) ng/l, (96.09 ± 34.19) ng/l (P<0.01). Significant difference was observed in mean serum and urinary VEGF levels between stage T1 superficially invasive disease and stage T2 or T3 muscle invasive disease (234.84 ± 33.56)ng/l,(137.95 ?...