Análise das dosagens do fator de crescimento endotelial vascular no plasma e fluidos peritoneais de pacientes com câncer epitelial de ovário

Abstract

Epithelial ovarian carcinogenesis has been the focus of scientific studies in developed world. The ovarian tumor angiogenesis is a multifactorial process that results in pro-angiogenic products. Among them, vascular endothelial growth factor (VEGF) is predominant. This study aimed to relate VEGF levels in peritoneal fluids, peripheric plasma and pelvic infundibular plasma to debulking levels in patients operated on for epithelial ovarian carcinoma (EOC), formulate a probabilistic model for debulking and use these measurements to estimate the probability of the outcome of debulking. Moreover, it was created a new variable called burden of VEGF. For step-wise procedure, cytoreduction was better described by of burden VEGF, but missed Normality of residuals, so the adequacy of a mathematical model was not possible. Nevertheless, the ROC curve provided an area under the curve of 0.84, with sensitivity of 71.4 % and especificity varying from 69.5 to 73,9%. The optimal cutoff point was 15.52 log of picograms of VEGF burden. An odds-ratio for optimal cytoreduction described by the VEGF burden was 11 (CI= 2.59; 46.78). In the group with advanced stages (III & IV), the OR was 6 (CI= 1.15; 31.22). Apart from the small number of cases, this new variable might help to determine situations where cytoreductive surgery leaves behind the cornerstone of primary treatment of CEO and the chemotherapic induction comes to have main role in chemical cytoreduction prior to surgery in these cases.