外周血血管内皮生长因子对中晚期宫颈癌患者同步放化疗效果的预测价值研究

Study on the value of vascular endothelial growth factor in peripheral blood in prediction of concurrent chemoradiotherapy effect for patients with middle and advanced cervical cancer

目的:探讨血清血管内皮生长因子(VEGF)与中晚期宫颈癌临床病理特征的关系及其对同步放化疗预后的预测价值。方法:选取58例经病理组织学证实为宫颈癌患者为研究组,另选取58例行妇科检查的正常者为对照组,采用酶联免疫法测定两组血清VEGF水平及宫颈癌患者同步放化疗前后血清VEGF水平,分析VEGF水平对宫颈癌患者同步放化疗后预后的影响。结果:宫颈癌组织VEGF水平为(241.76±85.87)μg/L,显著高于正常宫颈组织(124.65±65.87)μg/L。VEGF水平与肿瘤分化程度、临床分期、淋巴结转移有关,与患者年龄、肿瘤大小无关。血清VEGF在同步放化疗后的水平变化与患者病情缓解程度有关,其中完全缓解(CR)放化疗后血清VEGF水平均低于部分缓解(PR)及疾病进展(PD),差异有统计学意义(P<0.05)。VEGF高水平者(VEGF>197.85μg/L)放化疗有效率、3年生存率、平均生存时间显著低于VEGF低水平者(VEGF<197.85μg/L),差异有统计学意义(P<0.05)。结论:血清VEGF水平与宫颈癌分化程度、临床分期、淋巴结转移及同步放化疗近期疗效关系密切,血清VEGF可作为宫颈癌患者同步放化疗疗效的预测指标。

Objective： To explore the relationship between serum vascular endothelial growth factor （VEGF） and clinicopathologieal characteristics of middle and advanced cervical cancer and its value in predicting prognosis of concurrent chemoradiotherapy. Methods： Fifty - eight patients diagnosed as cervical cancer by pathohistological examination definitely were selected as study group, fifty - eight normal women after gynecological examination were selected as control group ; ELISA was used to detect the levels of serum VEGF in the two groups and serum VEGF levels before and after concurrent chemoradiotherapy in study group, the effect of VEGF level on prognosis of cervical cancer patients after concurrent chemoradiotherapy was analyzed. Results： The level of VEGF in study group was （241.76 ± 85. 87 ） μg/L, which was significantly higher than that in control group [ （ 124. 65 ±65.87 ） μg/L] . VEGF level was correlated with differentiated degree, clinical staging and lymph node metastasis, but there was no correlation between VEGF level and age, tumor size. The change of serum VEGF level after concurrent chemoradiotherapy was related to degree of remission of these patients, serum VEGF level of complete remission （CR） after concurrent chemoradiotherapy was statistically significantly lower than those of partial remission （PR） and progression of disease （PD） （P 〈 0. 05） . The effective rate of concurrent chemoradiotherapy, three - year survival rate and mean survival time in patients with high serum VEGF level （ VEGF 〉 197.85 μg/L） were statistically significantly lower than those in patients with low serum VEGF level （VEGF 〈 197.85 μg/L） （P 〈0. 05） . Conclusion： Serum VEGF level is closely correlated with differentiated degree, cfinical staging, lymph node metastasis and short -term curative effect of concurrent chemoradiotherapy, which can be used as an index to predict curative effect of concurrent chemoradiotherapy in cervical cancer patients.