Mesut MISIROĞLU, Özlem ALTINKAYA, Ebru ZÜLFİKAROĞLU, Aylin SAĞLAM, Tayfun GÜNGÖR

OVER TÜMÖRLERİNDE SERUM VEGF DÜZEYİNİN DİAGNOSTİK VE PROGNOSTİK DEĞERi

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

Anahtar Kelimeler:

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

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,

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