目的： 探讨消化道肿瘤患者手术前后血清血管内皮生长因子（vascular endothelial growth factor，VEGF）和Endostatin的动态变化规律及其与临床病理特征的关系。方法： ELISA法检测胃癌、肝癌、结直肠癌患者术前及术后2周血清VEGF和Endostatin水平，并分别以慢性胃炎、慢性乙型肝炎、结肠腺瘤患者和健康人群作对照。结果： 胃癌、肝癌、结直肠癌患者术前血清VEGF和Endostatin水平分别显著高于慢性胃炎、慢性乙型肝炎、结肠腺瘤患者及健康人群组（P<0.01）；术前血清VEGF、Endostatin水平与细胞分化程度、肿瘤大小、浸润深度、区域淋巴结转移、远处转移及临床分期密切相关(P<0.05)，与性别、肿瘤部位等因素无关(P>0.05)；术后2周血清VEGF水平较术前均有显著性下降(P<0.01)，而血清Endostatin水平较术前升高(P<0.01)。结论： 胃癌、肝癌、结直肠癌患者血清VEGF和Endostatin水平升高，且与肿瘤细胞分化程度、肿瘤大小、浸润深度、区域淋巴结转移、远处转移及临床分期密切相关,它们可推荐作为评价胃癌、肝癌、结直肠癌恶性行为、预测浸润和转移程度的有效指标。

Objective: To study the relationship between serum levels of vascular endothelial growthfactor (VEGF), endostatin and pathological characteristics of patients with gastrointestinal cancer. Methods:Serum VEGF and endostatin levels were measured by enzyme-linked immunoassay in 60 patients with gastric carcinoma, 55 with hepatocellular carcinoma, 58 with colorectal carcinoma before and after surgical resection (two weeks later) and in control groups, which included 30 patients with chronic gastritis, 30 with chronic hepatitis B, 30 with adenoma of colon and 30 healthy persons. Results: The preoperative levels of VEGF and endostatin in patients with gastric carcinoma, hepatocellular carcinoma and colorectal carcinoma were significantly higher than those in patients with chronic gastritis, chronic hepatitis B, adenoma of colon and healthy persons (P<0.01). The pre-operation VEGF and endostatin levels were closely related to the grades of cell differentiation, size of the primary tumors, depth of invasion, regional lymph-node metastasis, distant metastasis and pathological stage (P<0.01), but not to tumor site and sex (P>0.05). The post-operation VEGF levels were significantly lower than that of pre-operation (P<0.01), while postoperative endostatin levels were significantly higher than that of preoperation(P<0.01). Conclusion: Elevated serum VEGF and endostatin levels in patients with gastirc, hepatocellular and colorectal carcinoma are closely correlated to the grade of cell differentiation, size of the primary tumors, invasion, metastases and pathological stages. Serum VEGF and endostatin levels may be used for evaluating the biological behavior, invasion and metastasis of gastric, hepatocellular and colorectal carcinoma preoperatively.

山东省卫生厅科技资助项目（2001CA1CJB9）