乳腺癌患者血清VEGF和IGF-1联合检测的临床意义

摘要

目的 探讨血清VEGF和IGF-1的表达在乳腺癌临床诊断和预后判断中的意义.方法 42例乳腺癌患者、15例乳腺良性病变者和40例健康体检女性的血清VEGF和IGF-1的水平用ELISA方法测定,E2、PRL、HGH、CEA和CA-153的浓度用化学发光法测定,分析在ER、PR、C-erbB-2的表达和淋巴结转移等病理状态下指标的变化和相关性.结果 乳腺癌患者组血清VEGF、IGF-1水平显著高于乳腺良性疾病组和正常对照组(6.70±0.52,4.78±0.51,4.24±0.49;4.98±0.55,3.01±0.54,2.87±0.52),PRL水平显著高于正常对照组(3.26±1.03,2.44±1.48,P＜0.05);PR阳性者IGF-1水平显著低于PR阴性者(t=3.267,P=0.016),ER阳性者IGF-1显著低于ER阴性者(t=2.954,P=0.028).C-erbB-2阳性者E2、PRL水平显著高于C-erbB-2阴性者(t=2.768,P=0.009;t=2.072,P=0.047);HGH显著低于阴性者(t=2.974,P=0.005).淋巴结非转移者E2水平显著高于转移者(t=2.437,P=0.028);转移者CEA显著高于非转移组(t=2.352,P=0.036).结论 血清VEGF和IGF-1可以作为乳腺癌肿瘤生物学标志物.高水平IGF-1可能意味着治疗效果差、有淋巴结的转移.激素水平在肿瘤的发生发展中可能有作用.肿瘤标志物CEA对肿瘤的转移可能有预测的价值.%Objective Evaluating the clinical significance of serum VEGF annd IGF-1 in patients with breast cancer.Methods 42 cases of breast canncer,15 cases of benign breast disease and 40 cases of norm alwere involved .The serum VEGF and IGF-1 were determined with ELISA ,E2 ,PRL ,HGH ,CEA and CA-153 were determined with chemilum inescence method. The changing of above index were analyzed ,according to pathologic index of ER ,PR ,C-erbB-2 and lymphnode metastasis.Results The serum VEGF and IGF-1 level in breast cancer group were significantly higher than that in benign breast disease group and control group (6.70±0.52,4.78±0.51,4.24±0.49 ;4.98±0.55,3.01±0.54,2.87±0.52, P＜0.05 ).The serum level of IGF-1 in PR positive group was significantly lower than that in PR negative group( t=3.267,P =0.016).The level of IGF-1 in ER positive group was significantly lower than that in ER negative group(t=2.954,P = 0.028).The level of E2 and PRL in C-erbB-2 positive group were significantly higher than that in C-erbB-2 negative group(t=2.768,P =0.009;t=2.072,P =0.047);while the HGH was significantly lower than that in C-erbB-2 negative group(t=2.974,P =0.005) .The level of E2 in patients without lymphnode metastasis was significantly higher than that with lymphnode metastasis( t= 2.437, P =0.028 ),the level of CEA with lymphnode metastasis was significantly higher than that without lymphnode metastasis(t=2.352,P =0.036).Conclusion The serum level VEGF and IGF-1 have certain value to make differential diagnosis between malignant and benign breast diseases .The high level of IGF-1 may predict the possibility of prognosis and lymphnode metastasis .The horm one E2 ,PRL ,HGH and the tum or marker CEA and CA-153 may have the predict value in progression and lymphnode metastasis of breast cancer.