[The clinical value of vascular endothelial growth factor in patients with small cell lung cancer].

BACKGROUND: It is well-known that vascular endothelial growth factor (VEGF) relates to the oncogenesis and development and metastasis of cancer, and patients with small cell lung cancer (SCLC) often have poor prognosis, earlier metastasis and shorter survival. This study is designed to investigate the effect of VEGF on the oncogenesis and development of SCLC and the clinical significance and prognostic value of VEGF in patients with SCLC. METHODS: Serum VEGF level and pro-gastrin releasing peptide (ProGRP) level were measured using enzyme-linked immunosorbent assay (ELISA) in patients with SCLC before treatment and patients with benign lung diseases and in healthy persons, and serum neuron specific enolase (NSE) levels measured using radioimmunoassay. RESULTS: There were significant difference of serum VEGF level between the patients with SCLC and the patients with benign lung diseases and healthy persons (P < 0.05). Taking the mean concentration of serum VEGF as a cut-off, patients were divided into high VEGF (> 489.1 ng/L) and low VEGF (≤489.1 ng/L) groups, and the sensitivity and the specificity were 32.8% and 95.7% respectively. It was shown that the serum levels of VEGF in patients with SCLC didn't correlate with clinical features including age, gender, performance status and treatment, but correlated with disease staging (P < 0.05). High VEGF level was found more frequently in patients with extensive disease of SCLC than in those with limited disease (P < 0.05). The correlations weren't found between serum VEGF level and NSE level, ProGRP level in patients with SCLC (r=0.221, P > 0.05; r=0.217, P > 0.05). However, the positive rate of diagnosising SCLC was 54.1% by the determinant of serum VEGF allied serum NSE, 73.8% by the determinant of serum VEGF allied serum ProGRP and 78.7% by the determinant of serum VEGF allied se-rum NSE and serum Pro-GRP. Patients with high VEGF level had a significantly shorter overall survival time than those with low VEGF level in univariate survival analysis (P < 0.05). Further, the high VEGF level remained as a significantly determinant of poor survival in multivariate analysis (P < 0.05). CONCLUSIONS: There is a significant correlation between serum level of VEGF and survival in patients with SCLC. Serum VEGF may be regarded as a prognostic factor. The serum assay for VEGF using ELISA can be easily and repeatedly performed because of minimal invasiveness, hence serum VEGF measurement may be regarded as a subsidiary experiment of tumor marker in the patients with SCLC.