Maling ve benign efüzyonların ayırıcı tanısında vasküler endotelyal growth faktör(VEGF) düzeyi
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2017
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info:eu-repo/semantics/openAccess
Özet
Malign efüzyonlar n kesin tan s sitolojik veya histolojik olarak mümkündür. Ancak önemli bir hasta grubunda mükerrer sitolojik incelemelere ra men tan da zorluklarla kar la lmaktad r. Tan y do rulamak amac yla tümör mark rlar ve sitokinler olmak üzere birçok parametre çal lm t r. Yap lan baz çal malarda vasküler endotelyal büyüme faktörünün (VEGF) malign ve inflamatuar efüzyonlarda yükseldi i ortaya konmuştur. VEGF endotel hücreleri için bilinen en spesifik mitojenik faktördür. Vaskülogenezis ve anjiogenezde önemli rol oynar. Vücutta hem fizyolojik olaylarda hem de tümör büyümesi ve yay lmas da dahil olmak üzere birçok hastal n patagenezinde rol almaktad r. Bu çal mam zda amaç; VEGF düzeylerinin malign ve benign efüzyonlar n ay r c tan s ndaki önemini ara t rmakt r. Materyal ve Metod: Çal maya malign efüzyonu olan 25 hasta (hasta grubu) ve benign efüzyonlu 25 hasta (kontrol grubu) al nd . Malign hastalar 5 erli 5 gruptan olu tu (Over Ca; 5 hasta, Meme Ca; 5 hasta, Akci er Ca; 5 hasta, Malign mezotelyoma; 5 hasta, Mide Ca; 5 hasta). Kontrol hasta grubunu ise dekompanse karaci er sirozu (Hepatit B ve C ye ba l ) ve kalp yetmezli ine ba l efüzyon geli en hastalar olu turdu. VEGF düzeylerine hasta grubunda hem serum hem de efüzyonda, kontrol grubunda ise sadece efüzyonda bak ld . Bulgular: VEGF ortalamas hasta grubunun efüzyonunda 493,80 pg/mL bulunurken, kontrol grubun effüzyonda 15,43 pg/mL bulundu. Hasta grubunda VEGF düzeyi ortalamas anlaml yüksek saptand (p< 0.05). Hasta grubunun serum VEGF düzeyi ortalamas ise 49,90 pg/mL saptand . Hasta grubunun efüzyon ve serum VEGF düzeyleri aras ndaki fark istatistiksel olarak anlaml bulundu (p< 0.05). Alt gruplar incelendi inde en yüksek VEGF düzeyi Over Ca l (1052,37 pg/mL ) hastalar n efüzyonunda ölçüldü. En dü ük efüzyon VEGF düzeyi mezotelyomal hastalarda (66,59 pg/mL) ölçüldü. En yüksek serum VEGF düzeyi ise malign plevral mezotelyoma da (80,14 pg/mL) ölçüldü. En dü ük serum VEGF düzeyi AC Ca l hastalarda (29,21 pg/mL) ölçüldü. Sonuç: Daha önceki çal lan parametrelere ilave olarak VEGF düzeyinin, malign ve benign efüzyonlar n ay r c tan s nda iyi bir noninvaziv yöntem olarak kullan labilece ini dü ünmekteyiz. Anahtar kelimeler: Malign efüzyon, VEGF, Asit, Plevral effüzyon, Kan serumu.
The diagnosis of malign effusions is established by cytologically and histologically. But, in numareous patients, diagnosis can not be performed by recurrent cytologic investigations. Tumor markers and cytokines have been worked out for correction the diagnosis. Recent studies report high levels of vascular endothelial growth factor (VEGF) in malign and inflamatory effusions. Vascular endothelial growth factor (VEGF) is the most specific mytogenic factor for endothelial cells that has been known. It plays important roles in vasculogenesis and anjiogenesis. It has important roles in physicologic events in healthy body and pathological events such as tumor growing and metastasis. The aim of the study is to show the calculated VEGF levels in the serum and effusions of patients for the diagnosis of benign and malign effusions. Material and Method: 25 patients wtih malign effusion (patient group) and 25 patients with benign effusion (control group) are included the study. Patient group diveded into 5 subgroup, which contains 5 patients each. (Ovarian Carcinoma subgroup, Breast Carcinoma subgroup, Lung Cancer subgroup, Malign Pleural Mesotelioma subgroup, Stomach Cancer subgroup) Decompanse cirrhosis (results of Hepatitis B and C) patients and heart failure patients were studied as control group. VEGF levels were evaluated in blood serum and effusions in the patient group, and in effusions in the control group. Results: Avarage calculated VEGF levels were; 493.8025 pg/mL in the patient gruop s effusions and 15,4312 pg/mL in the control group s effusions. The avarage levels of VEGF in patient group were calculated highly statically (p<0.05). Avarage blood serum VEGF levels in the patient group was 49,9079 pg/mL. The differences of blood serum and effusion VEGF levels of the patient grup were meaningfull statically (p<0.05). In the patients group s subgroups; the highest effusion level of VEGF was evaluated in the ovarian carcinoma subgroup (1052,3788 pg/mL), the lowest level was evaluated in the malign pleural mesothelioma subgroup (66.59 pg/mL). The highest blood serum level of VEGF was evaluated in malign pleural mesothelioma subgroup (80.14 pg/mL), and the lowest blood serum level of VEGF was evaluated in the lung cancer subgroup (29.21 pg/mL). Conclusion: We think that evaluation of the VEGF levels, as additional to other diagnostic parametres, is usefull and non-invasive tecnique for the diagnosing of malign and/or benign effusions. Key Words: Malign effusion, VEGF, Peritoneal efusion, Pleural effusion, Blood serum.
The diagnosis of malign effusions is established by cytologically and histologically. But, in numareous patients, diagnosis can not be performed by recurrent cytologic investigations. Tumor markers and cytokines have been worked out for correction the diagnosis. Recent studies report high levels of vascular endothelial growth factor (VEGF) in malign and inflamatory effusions. Vascular endothelial growth factor (VEGF) is the most specific mytogenic factor for endothelial cells that has been known. It plays important roles in vasculogenesis and anjiogenesis. It has important roles in physicologic events in healthy body and pathological events such as tumor growing and metastasis. The aim of the study is to show the calculated VEGF levels in the serum and effusions of patients for the diagnosis of benign and malign effusions. Material and Method: 25 patients wtih malign effusion (patient group) and 25 patients with benign effusion (control group) are included the study. Patient group diveded into 5 subgroup, which contains 5 patients each. (Ovarian Carcinoma subgroup, Breast Carcinoma subgroup, Lung Cancer subgroup, Malign Pleural Mesotelioma subgroup, Stomach Cancer subgroup) Decompanse cirrhosis (results of Hepatitis B and C) patients and heart failure patients were studied as control group. VEGF levels were evaluated in blood serum and effusions in the patient group, and in effusions in the control group. Results: Avarage calculated VEGF levels were; 493.8025 pg/mL in the patient gruop s effusions and 15,4312 pg/mL in the control group s effusions. The avarage levels of VEGF in patient group were calculated highly statically (p<0.05). Avarage blood serum VEGF levels in the patient group was 49,9079 pg/mL. The differences of blood serum and effusion VEGF levels of the patient grup were meaningfull statically (p<0.05). In the patients group s subgroups; the highest effusion level of VEGF was evaluated in the ovarian carcinoma subgroup (1052,3788 pg/mL), the lowest level was evaluated in the malign pleural mesothelioma subgroup (66.59 pg/mL). The highest blood serum level of VEGF was evaluated in malign pleural mesothelioma subgroup (80.14 pg/mL), and the lowest blood serum level of VEGF was evaluated in the lung cancer subgroup (29.21 pg/mL). Conclusion: We think that evaluation of the VEGF levels, as additional to other diagnostic parametres, is usefull and non-invasive tecnique for the diagnosing of malign and/or benign effusions. Key Words: Malign effusion, VEGF, Peritoneal efusion, Pleural effusion, Blood serum.
Açıklama
Anahtar Kelimeler
Malign efüzyon, VEGF, Asit, Plevral effüzyon, Kan serumu, Malign effusion, Peritoneal efusion, Pleural effusion, Blood serum
