The clinical significance of vascular endothelial growth factor in malignant ascites
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Ascites can be caused by many kinds of diseases. Patients with undetermined ascites represent a diagnostic challenge. The aims of this study were to determine the diagnostic value of vascular endothelial growth factor (VEGF) in differentiation of malignant ascites from benign ascites and to investigate the clinical value of ascitic VEGF as an independent prognostic parameter. The study included 462 consecutive patients with malignant ascites and 550 patients with benign ascites, VEGF level in ascites were determined by a sandwich enzyme-linked immunosorbent assay. The survival rate was calculated by the Kaplan-Meier method and the log-rank test. Multivariate survival analysis was performed using the Cox hazards model. In our study, we found VEGF levels in malignant ascites (676.59 ± 303.86 pg/ml) were significantly higher than those in benign ascites (218.37 ± 98.15 pg/ml) (P < 0.001). Meanwhile, we also found that VEGF levels in malignant ascites from patients with ovarian cancer were higher than those with other cancers. Areas under the receiver operating characteristic (ROC) curves of ascitic VEGF was 0.940. At a cutoff value of 319.5 pg/ml, VEGF yielded a sensitivity of 89.2 % and a specificity of 88.4 %. Patients associated with the high-level VEGF value (≥613.38 pg/ml) in malignant ascites exhibited poor mean survival rates (8.3 ± 0.52 vs 15.11 ± 0.66 months, P < 0.001). In a multivariate Cox regression model, higher ascitic VEGF was an independent prognostic factor for overall survival. Planned subgroup analysis was performed for patients with tumor node metastasis (TNM) stage I. In the univariate analysis, only ascitic VEGF was associated with overall survival. VEGF was found to have a highly accurate sensitivity and specificity, suggesting that it could be considered as a new biomarker to differentiate malignant ascites from the benign one. The high level of VEGF value in malignant ascites may be used as an independent prognostic factor in patients with all stages of cancer.
KeywordsAscites VEGF Differential diagnosis Prognosis
This study was supported by a grant from the 2007 fund project of the Science and Technology research, Wuhan city, China (topic no. 200760423153).
Conflicts of interest
NZ designed the study, evaluated the ELISA results, and wrote the manuscript. XGL performed the statistical analyses. WGD designed the study. JW evaluated the clinical records.
All authors read and approved the manuscript.
- 24.DongWG SXM, Yu BP, Luo HS, Yu JP. Role of VEGF and CD44v6 in differentiating benign from malignant ascites. World J Gastroenterol. 2003;9(11):2596–600.Google Scholar
- 25.NI li. Combined detection of VEGF, ADA and LDH in differential diagnosis of benign and malignant ascites//CAI Haibin, Laboratory Medicine meeting of Zhejiang province, Hang Zhou, 2007.Google Scholar
- 26.Zhao XK. The clinical value of vascular endothelial growth factor in the diagnosis of malignant ascites. Taiyuan: Medical University of Shanxi; 2002.Google Scholar
- 27.Reb XF, Gong FL, Yao J. Investigation of vascular endothelial growth factor, collagen IV, III procollagen, hyaluronic acid and laminin in the diagnosis of in malignant ascites. Clin Focus. 2009;24(7):623–4.Google Scholar
- 28.Li Z, Chen WC, Su Y. Diagnostic value of the vascular endothelial growth factor in ascites. Chin J Pra Int Med. 2004;24(8):484–5.Google Scholar
- 29.Li Q, Dong WG. Soluble CD44 splice variants 6 and vascular endothelial growth factor in diagnosis of malignant ascites. Clin Med China. 2006;22(3):240–2.Google Scholar
- 32.Mu J, Abe Y, Tsutsui T, Yamamoto N, Tai XG, Niwa O, et al. Inhibition of growth and metastasis of ovarian carcinoma by administering a drug capable of interfering with vascular endothelial growth factor activity. Cancer Sci. 1996;87(9):963–71.Google Scholar
- 33.Yamamoto S, Konishi I, Mandai M, Kuroda H, Komastu T, Nanbu K, et al. Expression of vascular endothelial growth factor (VEGF) in epithelial ovarian neoplasms: correlation with clinicopathology and patient survival, and analysis of serum VEGF levels. Br J Cancer. 1997;76(9):1221–7.CrossRefPubMedPubMedCentralGoogle Scholar