血清E-cadherin、VEGF、nm23-H表达在同步放化疗的中晚期子宫颈鳞癌患者中的临床意义

Clinical significance of serum E-cadherin,VEGF,and nm23-H expressions in patients with advanced cervical squamous cell carcinoma undergoing concurrent radiotherapy and chemotherapy

目的 观察血清上皮型钙黏附蛋白(E-cadherin)、血管内皮生长因子(VEGF)、肿瘤转移抑制基因(nm23-H)在中晚期子宫颈鳞癌患者同步放化疗后的表达变化,探讨E-cadherin、VEGF、nm23-H的临床意义。方法 回顾100例同步放化疗治疗的Ⅱb/Ⅲ期子宫颈鳞癌患者临床资料,分析不同临床疗效、病情进展患者的E-cadherin、VEGF、nm23-H水平变化。结果 治疗敏感组淋巴结转移比例(12.99%)低于治疗抗拒组(34.78%),差异有统计学意义(χ^(2)=5.700,P=0.017)。治疗3月后,子宫颈癌Ⅲ期患者的血清E-cadherin、nm23-H mRNA水平低于Ⅱb期者,VEGF高于Ⅱb期者;治疗敏感组血清E-cadherin、nm23-H mRNA水平高于治疗抗拒组,VEGF水平低于治疗抗拒组;差异均有统计学意义(P<0.05)。随访1年间,复发8例、淋巴结转移11例、累积肿瘤进展19例,肿瘤进展患者的血清E-cadherin、nm23-H mRNA水平低于未进展患者、VEGF水平高于未进展患者,差异均有统计学意义(P<0.05)。结论 中晚期子宫颈鳞癌患者低水平E-cadherin、nm23-H及高水平VEGF影响其同步放化疗的敏感性,可能是引起肿瘤浸润、转移的重要原因。

Objective To observe the expression changes of serum E-cadherin, vascular endothelial growth factor(VEGF), and tumor metastasis suppressor gene(nm23-H) in patients with advanced cervical squamous cell carcinoma after concurrent radiotherapy and chemotherapy, and to explore the clinical significance of E-cadherin, VEGF, and nm23-H. Methods The clinical data of 100 patients with stage Ⅱb/Ⅲ cervical squamous cell carcinoma treated with concurrent radiotherapy and chemotherapy were reviewed, and the changes of E-cadherin, VEGF, and nm23-H levels in patients with different clinical efficacy and disease progression were analyzed. Results The proportion of lymph node metastasis in the treatment-sensitive group(12.99%) was lower than that in the treatment-resistant group(34.78%), and the difference was statistically significant(χ^(2)=5.700, P=0.017). After 3 months of treatment, the serum E-cadherin and nm23-H levels in patients with stage Ⅲ cervical squamous carcinoma were lower than those in patients with stage Ⅱb, while the VEGF level was higher than that in patients with stage Ⅱb. The serum E-cadherin and nm23-H mRNA in the treatment-sensitive group were higher than those in the treatment-resistant group, while the VEGF level was lower than that in the treatment-resistant group. The differences were statistically significant(P<0.05). During one year of follow-up, there were 8 cases of recurrence, 11 cases of lymph node metastasis, and 19 cases of cumulative tumor progression. The serum E-cadherin and nm23-H mRNA levels in patients with tumor progression were lower than those in patients without tumor progression, while the VEGF level was higher than that in patients without tumor progression. The differences were statistically significant(P<0.05). Conclusions Low levels of E-cadherin and nm23-H and high level of VEGF in patients with advanced cervical squamous cell carcinoma affect their sensitivity to concurrent radiotherapy and chemotherapy, which may be an important reason for tumor invasion and metastasis.