Maternal Serum Angiogenic Factor sFlt-1 to PlGF Ratio in Preeclampsia: A Useful Marker for Differential Diagnosis and Prognosis Evaluation in Chinese Women.

The ratio of soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) is elevated and proved to be useful in preeclampsia (PE) diagnosis. Its value in differential diagnosis with other pregnancy complications and prediction of pregnancy duration has yet to be clarified in Chinese population. We retrospectively analyzed 118 singleton pregnancies with suspected or diagnosed PE at the Peking Union Medical College Hospital (PUMCH) in China. Among these, 62 pregnancies were diagnosed as PE (48 early onsets and 14 late onsets, with 39 and 5 severe PE, respectively), 12 gestational hypertension (GH), 15 chronic hypertension (chrHTN), 16 autoimmune diseases, and 13 pregnancies with uncomplicated proteinuria. And 76 normal pregnancies were included as control. The results showed (1) the sFlt-1/PlGF ratio in early onset PE subgroup was significantly higher than that in GH, chrHTN, and control groups; the sFlt-1/PlGF ratio in late onset PE subgroup was significantly higher than that in chrHTN and control groups, but similar as GH group; the sFlt-1/PlGF ratio was similar among GH, chrHTN, and control groups. (2) The sFlt-1/PlGF ratio was significantly increased in the PE group compared with autoimmune disease and uncomplicated proteinuria pregnancies. (3) By ROC curve analysis, the cutoff value of the sFlt-1/PlGF ratio was less than 21.5 to rule out PE and higher than 97.2 to confirm the diagnosis of PE. (4) The sFlt-1/PlGF ratio was higher in PE pregnancies delivering within 7 days than those more than 7 days, either in early onset PE or severe PE. In conclusion, we show that maternal sFlt-1/PlGF ratio is an efficient biomarker in the diagnosis and differential diagnosis of PE. This ratio can be used to predict the timing of delivery for PE pregnancies.

[Prognostic value of microvessel density and angiogenesis-related molecules in epithelial ovarian cancer].

OBJECTIVE: To evaluate the correlations of microvessel density (MVD), vascular endothelial growth factor (VEGF), thrombospodin1 (TSP1) and p53 protein with prognosis in epithelial ovarian cancer. METHODS: Samples from 57 patients with primary epithelial ovarian cancer were examined by immunohistochemical staining using anti-VEGF, anti-TSP1, anti-p53 and anti-CD34 antibodies. The correlation of MVD, expression of VEGF, TSP1 and p53 protein with postoperative recurrence and overall survival were analyzed retrospectively. RESULTS: VEGF, TSP1 and p53 protein was positively detected in 40 (70.2%), 27 (47.4%) and 35 (61.4%) of those patients, respectively. The mean MVD in this series was 30.3 +/- 8.5. High MVD, positive VEGF expression and negative TSP1 expression were positively correlated with postoperative recurrence. Univariate analysis showed that patients with high MVD, positive expression of VEGF and p53 had shorter median overall survival time than those with lower MVD, negative expression of VEGF and p53 (P = 0.0187, P = 0.010 and P = 0.005, respectively), while TSP1 expression was revealed as a protective factor for prognosis. Patients with positive expression of TSP1 had longer median overall survival time than those with negative TSP1 expression (P = 0.042). Multivariate analysis showed that MVD and p53 expression were two independent prognostic factors in epithelial ovarian cancer (P = 0.018 and P = 0.009, respectively). CONCLUSION: VEGF, TSP1 and p53 protein may play an important role in the angiogenesis of epithelial ovarian cancer. High MVD level and p53 protein expression are two independent poor prognostic factors.

[Relationship of cyclooxygenase 2 expression and chemotherapy response and prognosis in human ovarian carcinoma].

OBJECTIVE: To investigate the relationship between expression of cyclooxygenase 2 (COX-2) and chemotherapy response and prognosis of patients with ovarian carcinoma. METHODS: The expression of COX-2 was detected by immunohistochemistry in ovarian carcinoma tissues. Correlations between COX-2 and clinicopathological markers, therapeutic effect and prognosis of the patients with ovarian carcinoma were analyzed by chi(2) test, Kplan-Meire and Cox model. RESULTS: COX-2 positive rate of 70 ovarian carcinomas was 60%. Expression of COX-2 was correlated with lymph nodes metastasis only (P = 0.001). There was no correlation between COX-2 and pathohistological types, clinical stage, pathohistological grade, age at diagnosis (P = 0.397, 0.094, 0.275, 0.394). In patients whose serum CA(125) level did not drop to normal after two courses of chemotherapy, the COX-2 positive rate (76%) was significantly higher than in those whose serum CA(125) level decreased obviously (51%, P = 0.042). The positive rate was also higher in patients with recurrent diseases (67%) than in those without recurrence (46%, P = 0.062). In univariate survival analysis, the expression of COX-2 was associated with a significantly reduced median survival time (P = 0.029). In multivariate survival analysis, COX-2 was an independent prognostic factor for poor survival (P = 0.036). CONCLUSION: COX-2 expression is correlated with poor chemotherapy response and prognostic outcome. It is an independent prognostic factor of ovarian carcinoma.