宫颈鳞癌新辅助化疗对血清VEGF及组织微血管密度的影响

Effect of neoadjuvant chemotherapy on the expression of MVD and the level of serum VEGF in cervical squamous carcinoma

目的检测宫颈鳞癌及新辅助化疗(NACT)前后血清血管内皮细胞生长因子(VEGF)和组织微血管密度(MVD)表达的变化,探讨其作为新辅助化疗疗效的预测指标的可行性。方法分别采用ELISA法和免疫组化SP法检测35例宫颈鳞癌直接手术组(对照组)和30例NACT组化疗前、后患者血清中VEGF水平和组织中MVD表达变化,分析新辅助化疗是否影响其变化。结果①NACT后,临床完全缓解3例,部分缓解21例,总有效率(CR+PR)为80%;②NACT组在化疗前与对照组血清VEGF水平和组织MVD表达差异无显著性(P>0.05);③NACT后宫颈鳞癌患者血清VEGF水平和组织MVD的表达在NACT前有明显降低(P<0.05);④MVD的表达和血清VEGF水平在临床有效组NACT后较NACT前出现显著下降(P<0.01),而临床无效组NACT前、后的表达差异无统计学意义(P>0.05)。结论NACT后MVD的表达及血清VEGF均明显下降,且与新辅助化疗疗效呈负相关。说明宫颈癌组织MVD的表达及血清VEGF可以成为NACT化疗疗效的预测指标。

Objective To investigate the effect of neoadjuvant chemotherapy （NACT） on the expression of microvessel density （MVD） and the serum VEGF level in advanced cervical squamous carcinoma .To discuss the feasibility of taking them as new predictive indexes for the effect of NACT. Methods The expressions of MVD were determined by means of immunohistochemistry in 35 cases of cervical squamous careinoma（control group） and 30 cases of cervical squamous carcinoma taking NACT （study group）.For patients taking NACT, the expressions of MVD were checked before and after the treatment respectively. Meanwhile, the level of serum VEGF in the same cases were measured by enzyme linked immunosorbent assay （ELISA）.The relationship between the changes of the two factors and the therapeutic effect of NACT, as well as the correlation of the expression of MVD in cervical carcinoma tissues and the serum VEGF level were analyzed. Results ① After NACT, the total efficient rate of NACT was 80%. ②Before NACT, there was no significant difference in the expressions of MVD and the level of serum VEGF between study group and control group. ③The expression of MVD and the level of serum VEGF decreased significantly after NACT compared with before. ④In patients who react to NACT, the expression of MVD and the level of serum VEGF decreased significantly after the treatment. But there was no such obvious change in other patients who react poorly to NACT. Conclusion The expression of MVD and the level of serum VEGF decreased significantly in patients who react to NACT. MVD and VEGF could be considered as new predictive indicators for therapeutic effect of NACT.