| BackgroundGastric carcinoma is one of the most common malignancies in the world. It has a higher morbidity and mortality. Although the5-year survival had improved in recent years, however, because of the lack of effective early diagnosis of gastric cancer, the vast majority of patients were of progressive or advanced stage gastric cancer, and the5-year survival rate was still between20%-30%, which seriously harmed people’s health and life. Invasion and metastasis of gastric cancer were the leading cause of death. Therefore, in-depth study on the mechanism of gastric cancer invasion and metastasis was the focus of today’s domestic and foreign scholars. Tumor growth and metastasis was a complex process influenced by many factors, which played an extremely important role in tumor angiogenesis, and this process was dependent on the balance between endogenous stimulating factors and inhibitory factors. Vascular endothelial growth factor (VEGF) and Endostatin were known angiogenesis-promoting factor and inhibitory factor, respectively. And they had the strongest effect in tumor angiogenesis. In recent years, there were more reports about VEGF and Endostatin. Studies had shown that liver cancer, colon cancer and lung cancer and other malignant tumors had high expression of VEGF and Endostatin, but rarely reported in gastric cancer; especially changes in serum levels of VEGF and Endostatin in advanced gastric cancer treated by chemotherapy have not been reported.ObjectiveBy testing changes of VEGF and Endostatin in advanced gastric cancer patients treated by chemotherapy, we could explore whether there was a certain correlation with the efficacy of chemotherapy; and could investigate the relationship between clinical pathophysiology of gastric cancer and VEGF, Endostatin. the correlation and prognosis between the two groups. So we could provide a theoretical basis for the clinical prognosis evaluation of gastric cancer.MethodsWith double antibody sandwich enzyme-linked immunosorbent assay(ELISA), we could quantitatively detect38cases of changes of VEGF and Endostatin in advanced gastric cancer patients treated by chemotherapy, and at the same time we detect20cases of changes of VEGF and Endostatin of chronic gastritis patients, and20cases of changes of VEGF and Endostatin in healthy people, and also compared these three groups. We adopted SPSS13.0statistical software for statistical analysis.ResultsThe serum levels of VEGF in patients with advanced gastric carcinoma before chemotherapy (454.81±169.49) pg/ml were significantly higher than that in patients with chronic gastritis (124.90±17.09) pg/ml and healthy persons (115.54±23.27) pg/ml,(P<0.01). The serum levels of Endostatin in patients with advanced gastric carcinoma before chemotherapy (86.05±15.86) ng/ml were significantly higher than that in patients with chronic gastritis (54.01±7.39) ng/ml and healthy persons (52.82±8.71) ng/ml,(P<0.01). but the serum levels of VEGF and Endostatin in patients with chronic gastritis and healthy people had no significant difference (P<0.01). Pearson correlation analysis showed that there was a significant positive correlation between serum VEGF and Endostatin levels in patients with advanced gastric carcinoma before chemotherapy, and the correlation coefficient was0.7549,(P<0.01). The serum levels of VEGF and Endostatin in advanced gastric cancer patients were not related to patients age, sex (P>0.05), but were closely related to pathological type, grade of cell differentiation, the efficacy of chemotherapy (P<0.05). The serum levels of VEGF in clinical benefit group of advanced gastric cancer patients decreased from (469.32±164.44) pg/ml before chemotherapy to (315.25±123.25) pg/ml after chemotherapy,(t=3.4357, P=0.0014); while serum Endostatin levels increased from (89.25±36.15) ng/ml before chemotherapy to (116.41±40.17) ng/ml after chemotherapy (t=2.3031, P=0.0266). The VEGF and Endostatin levels of the clinical ineffective group did not change significantly treated by chemotherapy (P>0.05). The serum VEGF levels of gastric cancer patients were higher than the average of 454.81pg/ml, and median survival was6.0months. But they were lower than the average of454.81pg/ml, median survival was9.5months, and the Log-rank test result was6.491, and it had significant statistic difference (P=0.011). Serum Endostatin levels of gastric cancer patients were higher than the average86.05ng/ml, and median survival was6.3months and it was blower than the average86.05ng/ml. Median survival was9.5months, and the Log-rank test result was4.482, and it had significant statistic difference (P=0.034).Conclusions1. The serum levels of VEGF and Endostatin in patients with advanced gastric carcinoma were significantly increased before chemotherapy, and there was a positive correlation between high levels of VEGF and Endostatin. We could speculate that VEGF and Endostatin might be involved in angiogenesis, and play an important role in the progress of gastric cancer.2. The serum levels of VEGF and Endostatin in advanced gastric cancer patients before chemotherapy were closely related to degree of cell differentiation, pathological type, and it could reflect malignant invasion ability of gastric cancer.3. Combined detecting the change in the level of serum VEGF and Endostatin treated by chemotherapy provided a new theoretical foundation for evaluation of the efficacy of chemotherapy for gastric cancer patients.4. The serum levels of VEGF and Endostatin before chemotherapy was related to the prognosis of the patients. And patients would have poor prognosis and short survival if their serum level was higher than the average ones. |
PDF Full Text Request