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
References
- 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. 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. 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. 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. 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. Oehler MK, Caffier H. Diagnostic value of serum VEGF in women with ovarian tumors. Anticancer Res. 1999;19(4A):2519-22.
- 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. 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. 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. 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. 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. 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. 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. 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. 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.
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.
References
- 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. 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. 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. 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. 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. Oehler MK, Caffier H. Diagnostic value of serum VEGF in women with ovarian tumors. Anticancer Res. 1999;19(4A):2519-22.
- 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. 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. 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. 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. 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. 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. 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. 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. 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.
Details
| Other ID | JA45TP42TN |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | October 1, 2013 |
| Submission Date | October 1, 2013 |
| Published in Issue | Year 2013 Volume: 16 Issue: 4 |