| Objectives:Malignant ascites would be confirmedly diagnosed by finding tumor cells in the ascites, but with low positive rate. So it was indispensable to seek appropriate cancerous markers in ascites. In this study, the results of VEGF and VEGF to the diagnosis of malignant ascites were discussed in this dissertation, after that we explored the risk factors of malignant ascites, the relevance of VEGF and telomerase with malignant ascites, and the role of VEGF and telomerase in the development of malignant ascites, so as to improve the accurate rate of diagnostic malignant ascites for clinical, and provided scientific basis for clinical diagnosis and treatment of ascites.Methods:Case control study was adopted in this study, according to the standard of case entry and removal, a total of 40 malignant ascites in the Affiliated Hospital of North China Coal Medical University a from 2007.9 to 2008.3 was recruited to be the case group, the benign ascites of the same term being hospitalized in hospital 40 case examples to be the control group, the reference standard for malignant ascites was clinical evaluation and ascites cytology with abdominal biopsy, and other examination in ascites. Index signs, the above-mentioned in ascites from patients were measured for each eligible case. By statistics analysis, the clinical significance of the diagnostic of malignancy ascites was observed. As did it if the clinically definite etiological diagnosis of ascites or the laboratory conclusive result of index test was absent finally. The VEGF and TERT were detected by Immunol cytochemistry SABC, and flaked by TCT Thin-Cytological Test, and the CEA, CA-50, CA-199, AFP and Ferritin were detected by radioimmunoassay; Biochemical detection of ascites were detected immunoturbidimetric assay.All of the datas were imported into Excel 2003 to establish, analyzed by SPSS 13.0 software: Measurement data with mean±standard deviation to express, frequencies of categorical variables were compared by Chi-square test; Quantitative variables were compared by student's independent t test. Non-condition logistic regression analysis was used to evaluate the relationship of telomerase and VEGF with malignant ascites, P levels of 0.05 or less were taken as special significant differences. P levels of 0.01 or less were taken as significantly statistically meaningful.Results:1. Characteristics of the studyAccording to the final diagnoses, 80 qualified cases concluded malignant ascites (40 cases) and nonmalignant ascites (40 cases). By t test andχ~2 test the difference of sex and age were not significant, significant difference with no statistical significance. The comparion between the case group and the control group, the distinctions of ALB, LDH, Ch, LZM were significantly statistically meaningful, P<0.05; and the distinctions of CEA, CA-50, CA-199, AFP, Ferritin were significantly statistically meaningful, P<0.05.2. The expression of VEGF in ascitesVEGF was mainly expressed in the cytoplasm of tumor cells in ascites, under the microscope appeared as cytoplasm in brown granules. Among 40 malignant ascites cases, VEGF was expressed as positive in 30 cases; among 40 nonmalignant ascites cases, VEGF was expressed as positive in 6 cases. By the test, the experiences of VEGF in malignant ascites were significantly higher than the experience in nonmalignant ascites, and the distinction was significantly statistically meaningful (χ~2=29.09,P<0.001).3. The expression of telomerase in ascites telomeraseTelomerase was mainly expressed in the nucleus of tumor cells in ascites, under the microscope appeared as nucleus in brown granules, Among 40 malignant ascites cases, telomerase was expressed as positive in 32 cases; Among 40 nonmalignant ascites cases, telomerase was expressed as positive in 4 cases. By the test, the experience of telomerase in malignant ascites was significantly higher than the experience in nonmalignant ascites, and the distinction was significantly statistically meaningful (χ~2=39.60,P<0.001).4. The relationship between the VEGF, telomerase and malignant ascitesBy logistic regression analysis: In this study information, the expression of VEGF, telomerase, CEA, AFP and ALB in the malignant ascites were risk factors, the OR values were 5.730 and 12.724, it was description that the expression of VEGF,telomerase in ascites with the malignant ascites remarkable correlation. But LZM appeared as a negative correlation with malignant ascites.Conclusions:The expressions of VEGF and telomerase ascites were independent risk factor in malignant ascites; VEGF, telomerase and malignant ascites with a significantly correlated, VEGF and telomerase were risk factors for malignant ascites; VEGF and telomerase possibly played important roles in the occurrence and development of the process malignant ascites. Detection of VEGF and telomerase probably provide new ideas for diagnosis of malignant ascites. |
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