Value Of Combined Detection Of Survivin And VEGF For The Differential Diagnosis Of Ascites

Backgroud:Ascites is a common clinical symptoms may be abdominal pelvic malignancies, liver cirrhosis, tuberculous peritonitis and other diseases. Different causes of ascites due to its treatment and prognosis of different, therefore, ascites causes, especially the identification of benign and malignant ascites is extremely important. Tumor cytology is a reliable method for diagnosis of malignant ascites, but due to falling in the ascites of cancer within the a limited number of cells, combined by the experience, technical conditions and other factors, the positive rate low, so, from the ascites to find high sensitivity, high specificity and easy detection of tumor markers to improve diagnostic accuracy rate of malignant tumors has important clinical significance. Survivin is a new member of the inhibitor of apoptosis protein family, the majority of tumor tissues have abnormal expression of survivin, cancer cells shed from the primary site to other parts through the settlement, proliferation of the final forming cancer metastasis, normal cells from the original organization that started when the apoptosis process, and thus will not form a distant parts proliferation. Survivin apoptosis through the inhibition of cancer cells to continue division and proliferation, resulting in tumor and adjacent parts of the formation of distant metastasis sites. Vascular endothelial growth factor (VEGF), also known as vascular permeability factor is a powerful biological effects and can produce a variety of cytokines, which comes mainly from tumor cells, through autocrine mechanisms to integrate in the VEGF receptors on tumor cells (VEGFR), thereby promoting tumor cell proliferation, migration, inhibit apoptosis, in addition, VEGF through paracrine mechanisms, and vascular endothelial cells in VEGFR binding to stimulate their division, proliferation, promoting their migration, enhanced vascular permeability in tumor angiogenesis and metastasis of tumor cells play an important role.Objective:To investigate the value of survivin and VEGF for differentially diagnosing ascites and the clinical significance of combined detection of survivin and VEGF.Metheds:A total of 62 ascites samples were collected,22 cases of benign ascites and 40 cases of malignant ascites. The levels of survivin and VEGF were determined by ELISA method.Result:①The survivin level and the VEGF level in malignant ascites were significantly higher than in benign ascites (p<0.01).②The survivin level and the VEGF level in malignant ascites of ovarian carcinoma were significantly higher than that of gastric carcinoma or pancreatic carcinoma or liver cancer (p<0.05).③The sensitivity, specificity,veracity of survivin to diagnosis the malignant ascites were 80%,86.4% and 82.3%.④The sensitivity, specificity,veracity of VEGF to diagnosis the malignant ascites were 67.5%,86.4%, and 74.2%. ⑤The sensitivity, specificity and veracity of combined detection of survivin and VEGF for malignant ascites were 90%,77.3% and 85.5% respectively.⑥Single detection of survivin compared with single detection of ascites VEGF:χ=0.941,P>0.05, the difference was not statistically significant. Single detection of VEGF compared with the combined detection of ascites survivin, VEGF:χ2=3.987, P<0.05, significant difference. Single detection of survivin compared with the combined detection of ascites survivin,VEGF:χ2=1.224,P>0.05,the difference was not statistically significant.⑦The expression of survivin was closely correlated to that of VEGF (p<0.01).Conclusion:The levels of survivin and VEGF in ascites might contribute to distinguish benign ascites from malignant ascites. The concentration of survivin and VEGF in malignant ascites might have a certain distinction value to originate of the malignant ascites. Combined detection of survivin and VEGF might have a significant value in the differential diagnosis of ascites.