Clinical Significance Of Detection Of Serum VEGF And NO In Pre- And Post-operative Patients With Gastric Carcinoma

Objective: Angiogenesis is essential for solid tumor growth and metastasis. Among many angiogenic factors, Vascular endothelial growth factor (VEGF) has been showed to play a major role in the development and dissemination of malignant tumors. Nitric oxide (NO) has been reported to play an important role for the mitogenic effect of VEGF in the angiogenic process. However, relatively little is known about the correlation between serum VEGF (s-VEGF) and NO (s-NO) in gastric carcinoma patients. This study was to investigate the relationship between s-VEGF and s-NO and clinicopathological parameters of gastric carcinoma, and to investigate whether s-VEGF and s-NO can be used as indexes for early diagnosis of gastric carcinoma.Methods: Serum levels of VEGF and NO were detected in 31 patients with primary gastric carcinoma who didn't received any prior therapy and 13 patients with chronic atrophic gastritis by enzyme-linked immunosorbant assay (ELISA) and spectrophotometry respectively. The gastric carcinoma patients consisted of 15 men and 16 women, raging in age from 27 to 68 years (mean 53.9 years). And we examined the influence of tumor stage as well as tumorload on serum concentrations of VEGF and NO.Results: 1. There was no significant difference with respect to patient gender, age and tumor differentiation. The levels of s-VEGF and s-NO in the patients with primary gastric carcinoma(268.40 137.71pg/ml, 63.19 20.76 umol/l) ,even with stage land II disease ( 180.14 54.94pg/ml, 50.10 14.40umol/l) , were significantly higher than those in control group ( 104.69 44.51 pg/ml, 38.26 16.57umol/l,P<0.05) .2. The levels of serum VEGF and NO increased in accordance with clinicalstage (180. 14 54.94 pg/ml, 50.10 14.40umol/l in stage I and II vs. 408.15 109.63 pg/ml , 83.90 8.50umol/linstage III and IV ) , which suggested that s-VEGF and s-NO were associated with tumor burden.3. The levels of s-VEGF and s-NO fell significantly on the first day after operation (101.87 51.70 pg/ml, 35.76 21.28 umol/1 vs.268.40 137.71 pg/ml , 63.19 20.76 umol/1 , P<0.05) ; there was no significant decrease in those who accepted palliative resections (P>0.05 ) .4. The increased level of s-VEGF was significantly associated with an elevated s-NO level (r=0.70,P<0.05) .5. At the level of 178pg/ml, s-VEGF suggested gastric carcinoma with a specificity of 92.31%, a sensitivity of 67.74%.Conclusion: 1.The levels of s-VEGF and s-NO were associated with tumor burden and clinicopathological parameters in gastric carcinoma patients;thus may be useful for clinical prognosis evaluation;2. The detection of s-VEGF and s-NO may serve as useful indexes for early diagnosis of gastric carcinoma.