Vascular endothelial growth factor levels in ascites between chemonaive and chemotreated patients

Purpose: Vascular endothelial growth factor (VEGF) levels in malignant ascites have high diagnostic value for their discrimination from asictes of non-malignant origin. However, there have been no reports on the comparison of VEGF levels between malignant ascites of chemonaive and chemotreated patients. Materials and Methods: VEGF levels were measured in 44 ascites patients (cirrhosis ascites, 10; chemonaive patients, 21; chemotreated patients, 13) and compared to the level of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9). The diagnostic parameters of sensitivity, specificity, and correlation among 3 markers were evaluated. Results: VEGF levels in malignant ascites of chemonaive and chemotreated patients were significantly higher than those in cirrhotic ascites (p < 0.05). VEGF levels in ascites of chemonaive patients were significantly higher than those in chemotreated patients (p < 0.05). A cutoff value of 10.4 pg/mL was calculated using receiver operating characteristic curves (ROCs) for VEGF in cbemotreated and chemonaive patients, which gave sensitivities of 75.0% and 53.8% and specificities of 69.6% and 47.1%, respectively. Positive correlations were observed between VEGF and CEA (r = 0.353, p < 0.05) as well as between VEGF and CA19-9 (r = 0.367, p < 0.05) in ascites. Conclusion: VEGF levels could be a useful tumor marker for malignant ascites, but its value should carefully be interpreted because of lesser reliability in chemotreated ones.