Significance Of Vascular Endothelial Growth Factor In Patients With Lung Cancer

Objective: To examine the expression of vascular endothelial growth factor(VEGF) and the level of serm and pleural effusion(PE) in patients with lung cancer and to evaluate its clinical significance.Methods: The expression of VEGF and the microvessel density(MVD) in 46 patients with non-small cell lung cancer was examined by immunohistochemistry methods. The corresponding serum level of VEGF was measured by enzyme-linked immunosorbent assay(ELISA),serum VEGF in 6 cases with lung cancer was continuous determined after operation. otherwise, the level of VEGF and carcinoembryonic antigen in 54 patients with benign and malignant pleural effusions was measueed by ELISA and chemiluminescence immunoassay(CLIA).Results: (1) The expression of VEGF was significantly higher(71.7%) in NSCLC than in paracancerous tissues(10.0%)(P<0.01), it had positive correlation with MVD. The expression of VEGF was higher in lung adenocarcinoma than that in squamous carcinoma(P<0.05),which increased with the lymphnode metastasis and advancing of TNM stage(P<0.01). In the VEGF positive group, the 4-year survival rate and a median survival time were 10.34% and 11.5 months,which was significantly lower than in the negative group(P<0.05). (2) The corresponding serum level of VEGF was significantly higher(333.35 ± 164.13pg/ml) in NSCLC than in health control group(74.85 ± 33.86pg/ml)(P<0.01),it had positive correlation with the expression of VEGF in NSCLC tissue.The serum VEGF increased with tumor local extension,lymph node metastasis and advancing of TNM stage(P<0.05),it decreased after the successful removal of tumor in 7 NSCLC patients,it was reelevated during relapse in 3 NSCLC patients. In the serumVEGF level>333pg/ml group, the 4-year surrival rate and a median surrival time were 0% and 5.5 month,which was significantly lower than in <333pg/ml group(P<0.01). (3) The VEGF level in PE was higher in malignant PE(420.83±201.80pg/ml) than in tuberculous (237.28 ± 139.03pg/ml) and transuadative PE(82.67 ± 42.24pg/ml), it provided a diagnostic test for malignant with a ROC of 0.799 and a sensitivity of 70.0% and a specificity of 83.3% and a accuracy of 72.92%.When it was co-examined with CEA, the diagnosis efficacy was increased relatively.Conclusion: Increased expression and serum level of VEGF may be closely related to the occurrence.development and metastasis of NSCLC, and is one of the factors predicting the worse prognosis of NSCLC. VEGF may be responsible for the maligment PE accumulation, the measurement of pleural VEGF is helpful in discriminating malignant and tuberculous effusions.