【摘要】 目的探讨术前测定血清血管内皮生长因子-C(serum vascular endothelial growth factor,SVEGF-C)浓度联合MDCT扫描能否判断胃癌淋巴结转移。方法ELISA方法测定80例胃癌患者及20例健康人SVEGF-C浓度,MDCT平扫及三期强化动态扫描,常规病理检查淋巴结有无转移。结果胃癌组SVEGF-C浓度为595.9±201.0pg/ml,对照组为360.0±97.4pg/ml(P=0.000);伴有淋巴结转移的58例胃癌患者SVEGF-C明显升高(650.9±198.6vs.451.0±115.5pg/ml,P<0.01);取临界点为542.5pg/ml时,SVEGF-C诊断淋巴结转移的敏感度为82.8%,特异度为81.8%,准确度为82.5%,阳性预测值为92.3%,阴性预测值为64.3%。MDCT诊断淋巴结转移的敏感度为51.7%,特异度为54.5%,准确度为52.5%,阳性预测值为75.0%,阴性预测值为30.0%。SVEGF-C联合MDCT诊断淋巴结转移的敏感度为91.4%,特异度为86.4%,准确度90%,阳性预测值94.6%,阴性预测值79.2%。结论术前SVEGF-C浓度测定可有效地判断胃癌淋巴结转移,联合MDCT扫描进一步提高准确度。更多还原

【Abstract】 Objective To investigate if serum vascular endothelial growth factor-C(SVEGF-C) and MDCT are related to lymph node metastasis(LNM) in gastric cancer.Methods The SVEGF-C levels of 80 patients and 20 donors were examined by ELISA.Both plain and enhanced MDCT scan of the upper abdomen were performed.Detailed pathologic findings were recorded.Results The level of SVEGF-C was higher in gastric cancer group than in control group(595.9±201.0 pg/ml vs.360.0±97.4 pg/ml).In the gastric cancer group,the higher level of SVEGF-C was found in LNM patients(650.9±198.6 vs.451.0±115.5 pg/ml,P<0.01).As a cutoff value being 542.5 pg/ml,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of SVEGF-C for predicating LNM was 82.8%,81.8%,82.5%,92.3%,64.3%,respectively.MDCT was used to detect LNM.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MDCT were 51.7%,54.5%,52.5%,75.0%,30.0%,respectively.SVEGF-C combined with MDCT was employed to diagnose LNM in gastric cancer.Its sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 91.4%,86.4%,90.0%,94.6%,79.2%,respectively.Conclusion SVEGF-C may be a biomarker for preoperative judgment of LNM,and SVEGF-C combined with MDCT can increase the accuracy of diagnosis of LNM in gastric cancer.更多还原