OVER TÜMÖRLERİNDE SERUM VEGF DÜZEYİNİN DİAGNOSTİK VE PROGNOSTİK DEĞERi

Abstract

Amaç: Bu çalışmada over tümörü tanısı alan hastalarda serum VEGF (vasküler endotelyal büyüme faktörü) düzeyinin serum fibrinojen, D-dimer ve tümör markerları düzeyleri ile korelasyonu ve bu hastalarda diagnostik ve prognostik değerinin değerlendirilmesi amaçlanmıştır. Materyal-Metod: Over tümörü ön tanısıyla opere olan 68 hastanın preoperatif serum VEGF, fibrinojen, D-dimer ve tümör markerları (Ca-125, Ca 19-9, Ca 15-3, CEA) düzeyleri belirlendi. 30 hasta epitelyal over kanseri, 38 hasta benign over tümörü tanısı aldı. Serum VEGF düzeylerinin tümör markerları, fibrinojen ve D-dimer düzeyleriyle ilişkisi analiz edildi. Sonuçlar: Epitelyal over kanseri grubunda benign over tümörü grubuna göre serum VEGF düzeyleri anlamlı olarak daha yüksekti. Serum VEGF düzeyinin 167 pg/ml cut-off değerinde over kanseri tanısında sensitivite, spesifite, pozitif prediktif değer ve negatif prediktif değeri sırasıyla %70, %68.4, %63.6 ve %72.4 olarak belirlendi. Epitelyal over kanseri grubunda preoperatif serum VEGF değeri ile Ca125, Ca 19-9, Ca 15-3, CEA, D-dimer, ve fibrinojen değerleri arasında ilişki saptanmadı (p>0.05). Cox regresyon analizi sonuçları cut-off de- ğeri üzerindeki serum VEGF düzeylerinin daha kısa survi ile korele olduğunu gösterdi. Tartışma: Bu verilere göre malign over tümörlerini ayırt etmede serum VEGF düzeyleri yararlı bir serolojik biomarker olarak kullanı- labilir. 167 pg/ml üzerindeki VEGF düzeyleri kanser sebepli ölüm için bağımsız risk faktörü olarak değerlendirilebilir

Keywords

• Vasküler Endotelyal Büyüme Faktörü, Fibrinojen, D-dimer, Epitelyal Over Kanseri.

Abstract

Background: The present study aimed to analyze the correlation of serum vascular endothelial growth factor (VEGF) with fibrinogen, D-dimer and tumor markers in patients with ovarian mass and to evaluate its diagnostic and prognostic value in these patients. Materials and Methods: Preoperative serum VEGF, fibrinogen, D-dimer levels and tumor markers (Ca 125, Ca19-9, Ca 15-3, CEA) were assessed in 30 women with epithelial ovarian cancer (EOC) and 38 women with benign ovarian tumors. VEGF concentration was determined by enzyme-linked immunosorbent assay (ELISA). The correlations of serum VEGF with Ca 125, Ca19-9, Ca 15-3, CEA, Ddimer and fibrinogen were also analyzed. Results: Serum VEGF levels in patients with EOC were significantly higher than those with benign ovarian mass. At a cut-off of 167 pg/ml; the sensitivity, specificity, positive predictive value and negative predictive values of serum VEGF levels for diagnosing ovarian carcinoma were 70%, 68.4%, 63.6% and 72.4%, respectively. No significant correlation was found between preoperative serum VEGF and Ca 125, Ca19-9, Ca 15-3, CEA, D-dimer and fibrinogen levels in the EOC group (p>0.05). Cox regression analysis showed that serum VEGF level over the cut-off value was correlated with shorter survival (p<0.001). Conclusion: These data suggest that VEGF may be a useful serological biomarker in differentiating benign adnexal masses from EOC. Preoperative VEGF levels >167 pg/ml are an independent risk factor for cancer related death.

Keywords

• Vascular Endothelial Growth Factor, Fibrinogen, Ddimer, Epithelial Ovarian Cancer

References

1. 1. Candido Dos Reis FJ, Moreira de Andrade J, Bighetti S. CA 125 and vascular endothelial growth factor in the differential diagnosis of epithelial ovarian tumors. Gynecol Obstet Invest. 2002;54(3):132-6.
2. 2. Li L, Wang L, Zhang W, Tang B, Zhang J, Song H et al. Correlation of serum VEGF levels with clinical stage, therapy efficacy, tumor metastasis and patient survival in ovarian cancer. Anticancer Res. 2004;24(3b):1973-9.
3. 3. Ma Y, Qian Y, Lv W. The correlation between plasma fibrinogen levels and the clinical features of patients with ovarian carcinoma. J Int Med Res. 2007;35(5):678- 84.
4. 4. Gadducci A, Cosio S, Tana R, Genazzani AR. Serum and tissue biomarkers as predictive and prognostic variables in epithelial ovarian cancer. Crit Rev Oncol Hematol. 2009;69(1):12-27.
5. 5. Koh SC, Khalil R, Lim FK, Ilancheran A, Choolani M. The association between fibrinogen, von Willebrand Factor, antithrombin III, and D-dimer levels and survival outcome by 36 months from ovarian cancer. Clin Appl Thromb Hemost. 2006;12(1):3-8.
6. 6. Oehler MK, Caffier H. Diagnostic value of serum VEGF in women with ovarian tumors. Anticancer Res. 1999;19(4A):2519-22.
7. 7. Gadducci A, Ferdeghini M, Fanucchi A, Annicchiarico C, Ciampi B, Prontera C et al. Serum preoperative vascular endothelial growth factor (VEGF) in epithelial ovarian cancer: relationship with prognostic variables and clinical outcome. Anticancer Res. 1999;19(2B):1401-5.
8. 8. Fasciani A, D’Ambrogio G, Bocci G, Luisi S, Artini PG, Genazzani AR. Vascular endothelial growth factor and interleukin-8 in ovarian cystic pathology. Fertil Steril. 2001;75(6):1218-21.

9. 9. Demirkiran F, Kumbak B, Bese T, Arvas M, Benian A, Aydin S et al. Vascular endothelial growth factor in adnexal masses. Int J Gynaecol Obstet. 2003;83(1):53-8.
10. 10. Cooper BC, Ritchie JM, Broghammer CL, Coffin J, Sorosky JI, Buller RE et al. Preoperative serum vascular endothelial growth factor levels: significance in ovarian cancer. Clin Cancer Res. 2002;8(10):3193-7.
11. 11. Hefler LA, Zeillinger R, Grimm C, Sood AK, Cheng WF, Gadducci A et al. Preoperative serum vascular endothelial growth factor as a prognostic parameter in ovarian cancer. Gynecol Oncol. 2006;103(2):512-7.
12. 12. Dehaven K, Taylor DD, Gercel-Taylor C. Comparison of serum vascular endothelial growth levels between patients with and without ovarian malignancies. Int J Gynecol Cancer. 2002;12(6):715-9.
13. 13. Rudlowski C, Pickart AK, Fuhljahn C, Friepoertner T, Schlehe B, Biesterfeld S et al. Prognostic significance of vascular endothelial growth factor expression in ovarian cancer patients: a long-term follow-up. Int J Gynecol Cancer. 2006;16 Suppl 1:183-9.
14. 14. von Tempelhoff GF, Dietrich M, Niemann F, Schneider D, Hommel G, Heilmann L. Blood coagulation and thrombosis in patients with ovarian malignancy. Thromb Haemost. 1997;77(3):456-61
15. 15. Gadducci A, Marrai R, Baicchi U, Ferdeghini M, Fanucchi A, Weiss C et al. Preoperative D-dimer plasma assay is not a predictor of clinical outcome for patients with advanced ovarian cancer. Gynecol Oncol.1997;66(1):85-8.