目的分析卵巢上皮性癌(卵巢癌)患者术前血清血管内皮生长因子(VEGF)与CA125水平的相关性,探讨术前血清VEGF水平在卵巢癌患者预后判断中的价值。方法采用酶联免疫吸附试验(EHSA)测定41例卵巢癌患者(研究组)库存的术前血清中VEGF的水平,采用化学发光法测定同一份血清的CA125水平;以同期20例盆腔检查正常的妇女作为对照组。结合随诊资料,分析卵巢癌患者术前血清VEGF水平与CA125水平的相关性,并分析术前血清VEGF水平与患者复发和生存时间的关系。结果(1)研究组术前血清VEGF和CA125水平均明显高于对照组(VEGF中位数分别为415和165ng/L,CA125分别为611和16kU/L),差异均有统计学意义(P〈0.01);(2)Spearman等级相关分析显示,卵巢癌患者术前血清VEGF水平与血清CA125水平间无明显相关性(P=0.989);(3)卵巢癌患者术前血清VEGF水平与其复发相关,复发者术前VEGF水平明显高于无复发者(中位数分别为490和315ng/L,P=0.035);(4)单因素Kaplan-Meier法分析显示,卵巢癌患者术前血清VEGF水平与其生存时间呈负相关,高血清VEGF水平者的生存时间明显短于低血清VEGF水平者(中位数生存时间分别为18个月和〉35个月,P=0.010);(5)多因素Cox回归模型分析显示,卵巢癌患者术前血清VEGF水平是与其生存时间有关的独立预后因素(P=0.042)。结论卵巢癌患者术前血清VEGF水平与CA125水平无明显相关性,VEGF水平变化是影响患者预后的独立因素。
Objective To analyze the correlation of preoperative serum vascular endothelial growth factor (VEGF) level with serum CA125 level in patients with epithelial ovarian cancer (EOC), and to evaluate the prognostic value of preoperative serum VEGF in these patients. Methods Forty-one patients with EOC were included as study group, while 20 healthy women were selected as control group. Enzyme-linked immunosorbent assay (ELISA) and chemiluminescence assay were used to measure serum VEGF and CA125 level respectively. The correlations of serum VEGF with CA125 level, postoperative recurrence rate and survival time were analyzed retrospectively. Results Serum VEGF levels in patients with EOC were higher than those in healthy women, with the median of 415 and 165 ng/L, range 110 -2120 and 100 -735 ng/L respectively( P 〈 0.01 ). No correlation was found between preoperative serum VEGF and CA125 level (Spearman test, P = 0.989). High preoperative serum VEGF was positively correlated with postoperative recurrence. Serum VEGF level in patients with postoperative recurrence was higher than that in patients without recurrence, with the median of 490 and 315 ng/L respectively ( P = 0. 035 ). Univariate analysis showed that higher serum level was reversely correlated with shorter survival. Median overall survival time in patients with higher serum VEGF level and lower serum VEGF level was 18 months and 〉 35 months respectively (P = 0. 010). Multivariate Cox model analysis showed that high VEGF level was an independent factor for the prognosis of EOC ( P = 0. 042 ). Conclusion Preoperative serum VEGF level is not correlated with CA125 concentration in patients with EOC, and it is an independent risk factor for prognosis.