Usefulness of plasma vascular endothelial growth factor in the diagnosis of pancreatic carcinoma - Differential diagnosis, tumor progression, and patient survival

Objectives: This study aimed to examine the usefulness of plasma vascular endothelial growth factor (p-VEGF) in patients with pancreatic carcinoma (PC) as a tumor marker for PC in comparison with chronic pancreatitis (CP) and to clarify the relationship between p-VEGF and the clinicopathological features of PC. Methods: The subjects were 69 patients with PC, 35 with CP, and 26 healthy volunteers (control group). The p-VEGF levels were measured by enzyme-linked immunoassay. Results: p-VEGF levels were significantly higher in the PC group compared with the CP and control groups (P < 0.0001). A cut-off level of 149.5 pg/mL, discriminating between PC and CP, was determined based on a receiver operating characteristic curve. Using this cut-off level, the sensitivity was 60%, specificity was 96%, and accuracy was 73%. Patients with PC with distant metastases exhibited a significantly higher level of p-VEGF compared with those without metastasis (P = 0.0113). Multivariate analysis indicated that a high level of p-VEGF was an independent prognostic factor, and a significant association was observed between p-VEGF and median survival time (P = 0.0092). Conclusions: p-VEGF proved useful in differentiating between PC and CP, and in patients with PC, a high level of p-VEGF may be a predictor of distant metastases and poor prognosis.