CAJ | 학술논문

目的：通过检测血清和胸水中血管内皮生长因子（VEGF）的水平，观察其对良恶性胸腔积液的鉴别诊断意义。方法收集解放军第一八四医院96例明确诊断为胸腔积液患者，其中恶性胸腔积液患者51例，为恶性组；良性胸腔积液患者45例，为良性组，应用电化学发光法检测两组患者血清及胸腔积液中 VEGF 的值，并与45例健康者血清 VEGF 水平作对照。结果恶性组血清 VEGF 水平为（90．87±35．36）pg/mL，胸腔积液 VEGF 水平为（985．36±523．63）pg/mL。良性胸腔积液组血清 VEGF 水平为（52．69±20．33）pg/mL，胸腔积液 VEGF 水平为（515．75±355．90）pg/mL。健康对照组血清 VEGF 水平为（30．88±7．22）pg/mL。其中良性胸腔积液组脓胸患者血清及胸腔积液 VEGF 水平与恶性胸腔积液组水平相近，差异无统计学意义（P ＞0．05）。良性组和恶性组血清及胸腔积液中 VEGF 水平比较：恶性组血清和胸腔积液中 VEGF 含量均显著高于良性胸腔积液组（P ＜0．05）。良性组血清 VEGF 水平显著高于健康对照组（P ＜0．05）。结核组及肺癌组血清及胸腔积液 VEGF 水平进行比较，结果显示肺癌组明显高于结核性胸膜炎组（P ＜0．05）。肺癌组不同病理类型血清及胸腔积液 VEGF 水平比较差异无统计学意义（P ＞0．05）。另外，肺癌患者初治前有远处转移组血清及胸腔积液水平[分别为（109．89±40．88）pg/mL，（1175．66±684．28）pg/mL]均明显高于尚未有远处转移组[分别为（71．79±36．37）pg/mL，（803．04±480．34）pg/mL]（P ＜0．05）。结论检测血清及胸腔积液中 VEGF 水平对于良恶性胸腔积液的诊断和鉴别诊断具有临床意义。VEGF 的测定可为癌症由无转移提供有效的参考指标。VEGF 的检测对癌症的分型不具有临床意义。胸腔积液中 VEGF 水平明显高于血清中。
목적：통과검측혈청화흉수중혈관내피생장인자（VEGF）적수평，관찰기대량악성흉강적액적감별진단의의。방법수집해방군제일팔사의원96례명학진단위흉강적액환자，기중악성흉강적액환자51례，위악성조；량성흉강적액환자45례，위량성조，응용전화학발광법검측량조환자혈청급흉강적액중 VEGF 적치，병여45례건강자혈청 VEGF 수평작대조。결과악성조혈청 VEGF 수평위（90．87±35．36）pg/mL，흉강적액 VEGF 수평위（985．36±523．63）pg/mL。량성흉강적액조혈청 VEGF 수평위（52．69±20．33）pg/mL，흉강적액 VEGF 수평위（515．75±355．90）pg/mL。건강대조조혈청 VEGF 수평위（30．88±7．22）pg/mL。기중량성흉강적액조농흉환자혈청급흉강적액 VEGF 수평여악성흉강적액조수평상근，차이무통계학의의（P ＞0．05）。량성조화악성조혈청급흉강적액중 VEGF 수평비교：악성조혈청화흉강적액중 VEGF 함량균현저고우량성흉강적액조（P ＜0．05）。량성조혈청 VEGF 수평현저고우건강대조조（P ＜0．05）。결핵조급폐암조혈청급흉강적액 VEGF 수평진행비교，결과현시폐암조명현고우결핵성흉막염조（P ＜0．05）。폐암조불동병리류형혈청급흉강적액 VEGF 수평비교차이무통계학의의（P ＞0．05）。령외，폐암환자초치전유원처전이조혈청급흉강적액수평[분별위（109．89±40．88）pg/mL，（1175．66±684．28）pg/mL]균명현고우상미유원처전이조[분별위（71．79±36．37）pg/mL，（803．04±480．34）pg/mL]（P ＜0．05）。결론검측혈청급흉강적액중 VEGF 수평대우량악성흉강적액적진단화감별진단구유림상의의。VEGF 적측정가위암증유무전이제공유효적삼고지표。VEGF 적검측대암증적분형불구유림상의의。흉강적액중 VEGF 수평명현고우혈청중。
Objective To explore the value of vascular endothelial growth factor (VEGF)in the serum and pleural effusion for identifying benign and malignant pleural effusions.Methods Ninety six patients diagnosed with pleural effusion were collected from the first eight four hospital of PLA ,51 patients with malignant pleural effusion divided as malignant group;45 patients with benign pleural effusion was divied into benign group,45 health people as the control group.electrochemiluminescence immunoassay method was used to detect the VEGF.Results In the malignant group ,the serum VEGF level was (90.87±35.36)pg/mL,the VEGF level of pleural effusion was (985. 36±523.63)pg/mL.In the benign group,the serum VEGF level was (52.69±20.33)pg/mL,VEGF levels of pleu-ral effusion was (515.75±355.90)pg/mL.The serum level of VEGF in healthy control group was (30.88±7.22) pg/mL.In the benign group,the serum and pleural effusion VEGF levels of empyema patients were similar to that of the malignant pleural effusion group,the difference had no significant (P >0.05).The serum and pleural effusion VEGF levels in patients of the malignant group were significant higher than that of the patients in the benign group (P <0.05).The serum VEGF level was significant higher than that of the control group(P < 0.05).The serum VEGF level of lung cancer group was significantly higher than that of tuberculous pleurisy group (P <0.05).There was no significant different among different pathological types of lung cancer(P >0.05).In addition,the serum and pleural effusion level (109.89±40.88 pg/mL;1 175.66±684.28 pg/mL)of the initial treatment of lung cancer pa-tients with metastasis were significantly higher than those in no distant metastasis group (71.79 ± 36.37 pg/mL;803.04±480.34 pg/mL)(P < 0.05).Conclusion Detection of VEGF level in the serum and pleural effusion has clinical significance for the diagnosis and differential diagnosis of benign and malignant pleural effusion.The determi-nation of VEGF could provide effective reference for whether the cancer have transferred .The detection of VEGF in different pathological types of lung cancer has no clinical significance.The VEGF level in the pleural effusion was significantly higher than that in serum.