Vascular endothelial growth factor in adnexal masses

Abstract

Objectives: To determine cyst fluid and serum vascular endothelial growth factor (VEGF) concentrations in patients with ovarian masses and to investigate the efficiency of this modulator in the clinical management of cystic pelvic masses. Methods: Needle puncture for cyst fluid aspiration were performed on 88 cystic ovarian masses intraoperatively. Forty-five patients with benign and 43 patients with malignant ovarian pathology were analyzed for cyst fluid and serum VEGF concentrations. Both cystic fluid and serum VEGF concentration were determined by enzyme-linked immunosorbent assay (ELISA). Results: Cyst fluid VEGF levels of malignant cysts (40.65 +/- 17.69 ng/ml) were significantly higher than those of benign cysts (12.53 +/- 6.13 ng/ml; P < 0.001). Similarly, higher serum VEGF concentrations were found in patients with malignant disease (0.72 &PLUSMN; 0.17 ng/ml) compared with benign cysts (0.33 &PLUSMN; 0.11 ng/ml; P < 0.001). A statistically significant correlation was observed between cyst fluid and serum VEGF levels in both malignant and benign cysts. For serum VEGF, at a cut-off value of 0.41 ng/ml; sensitivity, specificity, PPV, and NPV were 95%, 78%, 80% and 95%, respectively. No significant correlation between cyst fluid VEGF concentration and tumor stage or grade could be found. Conclusions: Significantly higher concentrations of VEGF are present in cyst fluid and serum of patients with malignant ovarian cysts compared with benign ovarian ones. There is no relation between VEGF and tumor stage or grade. (C) 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved.