摘要
目的 探讨结直肠癌患者术前血清血管内皮生长因子（VEGF）、白细胞介素6（IL-6）和C反应蛋白（CRP）水平与临床病理的关系及其对预后的临床意义.方法 采用酶联免疫吸附法检测79例结直肠癌患者血清VEGF和IL-6,采用免疫比浊法检测血清CRP,比较结直肠癌患者与健康对照者的血清VEGF、IL-6和CRP水平.采用Kaplan-Meier法分析结直肠癌患者5年生存率,采用Log rank 单因素分析预后不良因素.结果 结直肠癌组血清VEGF、IL-6和CRp分别为（591±312）pg/ml、（13.2±3.7）pg/ml和（1.14±0.87）mg/dl,健康对照组分别为（321±210）pg/ml、（5.4±2.0）pg/ml和（0.39±0.35）mg/dl,其中VEGF和CRP间差异有统计学意义（P＜0.001,P=0.002）.男性患者和女性患者的VEGF水平分别为（638±387）pg/ml和（552±271）pg/ml,差异有统计学意义（P=0.042）;肿瘤＜5 cm和肿瘤≥5 cm患者的VEGF表达分别为（538±275）pg/ml和（647±331）pg/ml,差异有统计学意义（P=0.009）.男性患者和女性患者的IL-6表达分别为（11.7±3.2）pg/ml和（15.2±4.0）pg/ml,差异有统计学意义（P=0.011）.VEGF＜591 pg/ml和≥591 pg/ml患者的5年生存率分别为86.8%（33/38）和73.2%（30/41）,IL-6＜13.2 pg/ml和≥13.2 pg/ml患者的5年生存率分别为82.9%（34/41）和76.3%（29/38）,CRP＜1.14 mg/dl和≥1.14 mg/dl的5年生存率分别为81.4%（35/43）和77.8%（28/36）.Log rank单因素分析显示,VEGF水平是影响结直肠癌预后的相关因素（P＜0.05）.Logistic回归分析显示,肿瘤大小和VEGF水平为结直肠癌患者预后的危险因素（P=0.032,OR=0.985;P=0.011,OR=0.976）.结论 血清VEGF和IL-6表达具有性别差异,血清VEGF检测可作为结直肠癌患者的临床诊断标志之一,对患者的预后具有重要的临床意义.
Objective To determine the preoperative serum VEGF, IL-6, and CRP levels in colorectal carcinoma, and to explore their correlation with disease status and prognosis. Methods Serum VEGF and IL-6 levels were assessed using ELISA, and CRP was measured by immunoturbidimetry. They were compared between the colorectal carcinoma group and the control group. The five-year survival rate and poor prognostic factors were analyzed by Kaplan-Meier and Log-rank method, respectively. Results The serum VEGF, IL-6, and CRP levels in colorectal carcinoma were （591 ±312） pg/ml, （13.2 ±3.7） pg/ml,and （1.14 ±0.87） mg/dl, respectively, higher than that in the control group. The two groups showed significant difference in VEGF and CRP （ P 〈 0.001, P = 0.002）. VEGF expression was higher in male than that in female [（638 ±387） pg/ml vs. （552 ±271） pg/ml, P =0.042]. The cases with tumor size smaller than 5 cm had lower VEGF expression compared with that in cases with tumor size ≥ 5 cm[（538 ±275） pg/ml vs. （647 ± 331 ） pg/ml, P = 0.009 ]. IL-6 expression showed significant difference in males （ 11.7 ±3.2） and females （ 15.2 ±4.0） pg/ml, （ P =0.011 ）. The five-year survival rate in the group with VEGF 〈591 pg/ml was 86.8% （33/38）, higher than that in the ≥591 pg/m group. High VEGF level tended to reduce survival （x2 =0. 933, P=0.344）. VEGF≥591 pg/ml was a factor of poor prognosis in colorectal carcinoma, assessed by Log-rank methods （ P 〈 0.05）. Tumor size and VEGF concentration were risk factors of prognosis （P=0.032, 0R=0.985;P=0.011, OR=0.976）. Conclusions Serum VEGF and IL-6 expressions have gender differences. Serum VEGF can be used as a biomaker of clinical diagnosis of colorectal cancer, and has an important significance on the prognosis of patients.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2010年第10期795-799,共5页
Chinese Journal of Oncology
关键词
结直肠肿瘤
预后
血管内皮生长因子
白细胞介素6
C反应蛋白
Colorectal neoplasms
Prognosis
Vascular endothelial growth factor
Interleukin-6
C-reactive protein
作者简介
通信作者：李兆沛，Email：lzp197409070427@163．com.
