血清VEGF水平对中晚期宫颈癌诊断价值及同期放化疗疗效影响研究

摘要

目的 探讨血清血管内皮生长因子(VEGF)水平对宫颈癌诊断价值及其同期放化疗预后影响.方法 选择经病理证实的中晚期宫颈鳞状细胞癌80例、慢性宫颈炎20例、体检健康人20例作为研究对象.酶联免疫吸附分析法测定研究对象血清VEGF基线水平,以及宫颈癌患者同期放化疗后3个月VEGF水平,分析其与临床疗效关系.结果 基线水平宫颈癌患者血清VEGF水平为237.36 μg/L,明显高于慢性宫颈炎和健康者(142.36μg/L,t=4.03,P=0.000).血清VEGF水平与肿瘤临床分期、分化程度及淋巴结转移密切相关,VEGF诊断宫颈癌的最佳界质为＞197.52 μg/L,敏感性为0.88,特异性为0.72.VEGF在同期放化疗前后变化与疗效关系密切,完全缓解者变化明显大于进展者,VEGF基线高水平者进展或死亡明显高于低水平者.结论 血清VEGF水平对宫颈癌诊断价值不高,与宫颈癌分期、分级及淋巴转移密切相关,对宫颈癌同期放化疗预后具有一定预测价值.%Objective To investigate the diagnostic value of serum vascular endothelial growth factor (VEGF) level for cervical cancer and its relationship with the therapeutic efficacy of concurrent chemoradiotherapy (CCRT).Methods Eighty patients with a pathologically confirmed diagnosis of advanced cervical squamous cell carcinoma (CSCC),20 patients with chronic cervicitis,and 20 healthy persons (as controls) were enrolled in the study.The CSCC patients received CCRT.All the subjects had their baseline serum VEGF levels measured by enzyme-linked immunosorbent assay (ELISA);also,the CSCC patients had their serum VEGF levels measured by ELISA at 3 months after CCRT.The relationship between the serum VEGF levels and therapeutic efficacy of CCRT was analyzed.Results The CSCC patients had a significantly higher baseline serum VEGF level than the chronic cervicitis patients and controls (237.36 μg/L vs.142.36 μg/L,t =4.03,P =0.000).The serum VEGF level was closely related to tumor stage,tumor differentiation,and lymph node metastasis.A serum VEGF level above 197.52 μg/L was the optimal cut point for diagnosing cervical cancer,with a sensitivity of 0.88 and a specificity of 0.72.The serum VEGF levels before and after CCRT showed a close relationship with the therapeutic efficacy.The patients achieving a complete remission had a significantly greater change in serum VEGF level than those with progression; the patients with high baseline serum VEGF levels had a significantly higher tumor progression or death rate than those with low baseline serum VEGF levels.Conclusions Serum VEGF level has poor diagnostic value for cervical cancer,though it is closely related to the tumor stage,tumor differentiation,and lymph node metastasis of cervical cancer.However,serum VEGF level has some predictive value for the therapeutic efficacy of CCRT in patients with cervical cancer.