A Study On The Levels Of Serum Vascular Endothelial Growth Factor (VEGF) In Patients With Breast Cancer And Its Clinical Significance

Objectives: Angiogenesis is essential for tumor growth and metastasis. The primary tumor beyond a critical mass is capable of stimulating angiogenesis. The switch to the angiogenic phenotype involves changes in the ocal equilibrium of cytokines with either pro-or anti-angiogenic properties. Vascular endothelial growth factor (VEGF) is believed to be one of the key factors capable of stimulating tumor angiogensis. VEGF is overexpressed by various types of malignant tumor cells , including breast cancer . In breast, cancer, VEGF is known to be responsible for promoting the neovascularization and also associated with tumor growth and metastasis. High tumor level of VEGF is correlated with poor survival. Recently, increased serum concentrations of VEGF have been reported in patients with various types of cancer. Tumor cell is the major source of circulation VEGF, and serum VEGF level is correlated with the expression of VEGF. The aim of this study was to determine the concentration of serum VEGF of breast cancer, and investigate the correlation between serum VEGF and cl inicopathologic feature in women with breast cancer. And the more important is that it gives us a new idea on surveillance of disease by detecting serum VEGF level and an idea on anticancer treatment. Methods: Pretreatment serum VFGF was measured in 68 women with breast cancer(49 case) or benign breast tumor (19 case),18 metastatic breast cancer and compared with serum levels in 20 healthy female controls. Peripheral venous blood were collected in a plain tubes before treatment. The serum was separated and stored at ~70℃ until a batch analysis for VEGF was performed.This assay uses the quantitative enzyme-linked immunosorbent (EL1SA) technique. A biotinylated antibody specific for VEGF is used to captured the VEGF, and peroxiclase conjugated antibody specific for VEGF is used for quantification. Standard specimens are ginen.Using substrate tetramethylbenzidine and the average absorbance values (A 450) for each sample, compared with standard curve,the concentration of VEGF was determined. Concentrations are reported as pg/ml. Statistical analysis was performed. Result: Serum VEGF in primary breast cancer is 116.2 pg/ml (median, interquartile rang from 13. 3 pg/ml to 279. 2 pg/ml ) , in health controls is 26.3 pg/ml(median, interquartile rang 11.8 pg/ml to 90.2 pg/ml). The serum levels of the breast cancer patients as a group were significantly elevated compared with those of the controls (P<0. 05 ) ,and benign breast cancer (median 42.4 pg/ml interquartile rang 8.6-101.3 pg/ml).If the 95 percentile of VEGF levels(107. ling/ml) was taken as the upper limit of normal, 32 (65. 7%)of 49cases with breast cancer showed serum VEGF levels above it. The highest serum VEGF levels were measured in patients with met astatic breast cancer (median 192.5 pg/ml interquartilerang from 1 7. 6to 295 . 8pg/ml), significantly higher than primary breast cancer and health controls(P<0.05). Serum VEGF levels is higher in patients with ductal cancer ( than in those with lobular cancer (P<0.05). Significant differences were observed, when serum VFGF was categorized by TNM stage (IV, III stage vs II , I stage P<0.05).No significant differences was found between serum VEGF and axillary lymph node status, histological grade (p>0.05).Conclusion: The results indicate that serum VEGF levels of patients with breast cancer were elevated compared with normal controls and patients with benign breast lesions . Higher serum VEGF levels were detected in patients with breast cancer of IV, III stage. The primary ductal cancer is associated with higher serum VEGF than lobular cancers. Serum VEGF level is oftenelevated in breast cancer with distant metastases compared with no distant metastases. Serum VEGF was associated with the development, invasion, metastasis of breast cancer. The dissemination of breast cancer may be accompanied by an elevation of serum VEGF levels. Our findings suggest that serum VEGF should be considered as a tumor marker for breast cancer progression and an...