新疆地区局部晚期宫颈癌血清 VEGF-C、D 水平与淋巴结转移及放疗后复发的相关性

摘要

目的：探讨新疆地区宫颈癌血清VEGF-C、D亚型水平与淋巴结转移及放疗后复发或淋巴结转移的相关性。方法纳入拟行根治性放化疗的宫颈鳞状细胞癌患者100例，采集血液标本，行根治性放化疗，并进行1年期随访， ELISA法检测血清VEGF-C、D亚型水平，分析治疗前VEGF-C、D与淋巴结转移的相关性，以及治疗后VEGF-C、D与复发或淋巴结转移的相关性。结果治疗前无淋巴结转移58例，一级淋巴结转移31例，二级淋巴结转移11例，血清VEGF-C水平分别为（136．93±68．56）pg／ml，（147．77±76．43）pg／ml，（258．72±98．71）pg／ml，差异有统计学意义（F＝12．45，P＝0．001）；血清VEGF-D分别为（2237．41±472．38）pg／ml，（2163．43±498．26）pg／ml，（2282．31±509．76）pg／ml，差异无统计学意义（F＝0．339，P＝0．71）。治疗后1年随访，患者全部存活，11例出现复发或淋巴结转移，余89例未出现复发或淋巴结转移，2组患者在治疗前血清VEGF-C分别为（251．33±121．39） pg／ml，（141．62±73．31） pg／ml，差异有统计学意义（t＝3．24，P＝0．001），在治疗后VEGF-C分别为（327．91±73．12） pg／ml，（153．31±49．38） pg／ml，差异有统计学意义（t＝10．45，P＜0．001）；而VEGF-D在治疗前后均无统计学差异。结论血清VEGF-C水平与宫颈癌淋巴结转移明显相关，测定其血清含量有助于宫颈癌治疗前阳性淋巴结的辅助诊断，以及放疗后复发或淋巴结转移的判定。而VEGF-D水平与淋巴结转移无明确关系。%Objective To investigate the correlation of serum VEGF-C、D level with lymph metastasis and and recur-rence after radiotherapy of cervical cancer in Xinjang .Methods 100 cases of cervical squamous cell carcinoma were recruited , and the blood samples were collected and well conserved .All the patients were experienced radical chemotherapy ,and 1-year fol-low-up were conducted .Then the serum VEGF-C,D level before and after treatment were detected by ELISA assay .The correla-tion of serum VEGF-C、D level with lymph and and recurrence after radiotherapy were analyzed .Results Before treatment ,there were 58 cases without lymph node metastasis ,31 cases with regional lymph node metastasis ,and 11 cases with non-regional lymph node metastasis,and their serum VEGF-C were 136.93 ±68.56 pg/ml,147.77 ±76.43 pg/ml,258.72 ±98.71 pg/ml,the difference was statistically significant (F=12.45,P=0.001).There were 11 cases who recurred in lymph node 1 year after treat-ment,and their serum VEGF-C before theatment were 251.33 ±121.39 pg/ml,which were statistically higher than those of lymph node negative patients (89 cases,141.62 ±73.31 pg/ml,t=3.24,P=0.001),and significant difference were observed between their VEGF-C level post treatment(t=10.45,P<0.001).The VEGF-D had no statistically significant difference before and after treatment.Conclusion Serum levels of VEGF-C is significantly associated with cervical lymph node metastasis ,measure serum VEGF-C levels will be beneficial for the diagnosis of lymph node metastasis before treatment ,and lymph node recurrence after ra-diotherapy .The VEGF-D levels have no clear relationship with lymph node metastasis .