A Clinical Epidemiological Study On Relationship Between Serum Vascular Endothelial Growth Factor And The Malignant Tumors

Objective To study the serum level of vascular endothelial growth factor (VEGF) in patients with malignant tumors , to elucidate the relation of its level with clinical pathological characteristics and neoplasm metastasis, and also to evaluate the clinical significance of VEGF and common tumor markers in the diagnosis, treatment and prognosis of malignant tumors.Methods The levels of serum VEGF were measured by sandwith enzyme linked immunosorbent assay (ELISA) in 544 patients with malignant tumors and in 87 healthy subjects, The immunoradiometric assay (IRMA) was used to measure the serum levels of 7 tumor markers including CEA, CA50, etc. in 544 patients with malignant tumors at the same time. Statistical analyses of data were performed by using the SPSS 10.0 software package. Means and standard deviations of different groups were calculated for describing the central tendency and tendency of dispersion, statistical significance were analyzed by the methods of t test, one-way ANOVA, LSD-t test or SNK-q test. Sensitivity, specificity, positive predictive value and negative predictive value of VEGF detection were calculated respectively, and the positive rates of different tumor markers in patients with various kinds of common malignant tumors were compared by chi square test. The relationship between the positive rates and the clinical effect were also analyzed.Results 1. The serum VEGF levels in patients with all kinds of malignant tumors were higher than those of healthy persons, the mean of serum VEGF were relativelyhigher in patients with gastric cancer, liver cancer and lung carcinoma. 2. The levels of serum VEGF in patients with tumor burden or recurrence were significantly higher than those in patients without tumor burden or recurrence (P<0.001 ) .3. The levels of serum VEGF were positively correlated with tumor size, vessel invasion, grade of differentiation (Pathobiology), depth of invasion, lymph node metastasis, distant metastasis and clinical pathological stage (P<0.01), but not significantly correlated with age and gender. With the decrease of the KPS grade, the levels of serum VEGF in the patients with malignant tumor increased. 4. According to the cutoff of medicine reference of VEGF (200.6ng/L), its sensitivity and specificity were 54.2% and 95.4% respectively. There was a significant difference between the sensitivity of serum VEGF in patients with tumor burden (74.9%) and that in patients without tumor burden (20.4%) (P<0.01) .5. The sensitivity of serum VEGF was varied among patients with different groups of common malignant tumors, such as 78.0% in liver cancer, 59.6% in lung cancer, 55.8% in gastric cancer, 53.2% in colon-rectal cancer, 44.4% in esophageal cancer and 23.4% in breast cancer. 6. Among the positive rate of the indexes above-mentioned, the highest one was VEGF (54.2%), the second was AFP(30.8%), all the other 6 tumor markers were below 20%. 7. The positive rates of VEGF in patients with tumor burden were higher than those in patients without tumor burden (P