VEGF及INH-A与妊娠滋养细胞肿瘤患者血hCG转阴时间的关系

Correlation of VEGF and INH-A with the blood hCG negative conversion time in patients with gestational trophoblastic neoplasms

目的研究血管内皮生长因子(VEGF)及抑制素A(INH-A)与妊娠滋养细胞肿瘤(GTN)患者血人绒毛膜促性腺激素(hCG)转阴时间的关系。方法回顾性选取2019年4月至2022年9月重庆市大足区人民医院收治的87例GTN患者,收集患者临床资料,检测其治疗前血清VEGF、INH-A、hCG水平,记录患者hCG转阴时间;采用Logistic回归分析分析hCG转阴时间的危险因素;Pearson法分析血清VEGF、INH-A水平与hCG转阴时间的相关性。结果患者治疗前VEGF水平为(342.16±93.25)pg/mL,INH-A水平为(9.51±4.36)pg/mL,hCG水平为(1745.32±451.37)IU/L。患者血hCG转阴时间为8~248 d,平均(64.58±10.16)d。不同前次妊娠性质、距前次妊娠终止时间的hCG转阴时间比较,差异均无统计学意义(P>0.05),年龄≥40岁、治疗前hCG水平≥10000 IU/L、FIGO评分≥13分、VEGF水平上升、INH-A水平下降的患者hCG转阴时间显著高于年龄<40岁、治疗前hCG水平<10000 IU/L、FIGO评分<5分、VEGF正常、INH-A水平正常的患者,差异均有统计学意义(P<0.05)。Logistic回归分析显示,hCG≥10000 IU/L、FIGO评分≥5分、VEGF水平上升、INH-A水平下降为hCG转阴时间延长的影响因素(OR=2.431,95%CI:1.532~3.855;OR=1.022,95%CI:1.004~1.040;OR=1.041,95%CI:1.016~1.066;OR=2.156,95%CI:1.431~3.247;P<0.05)。Pearson相关性分析,结果显示,VEGF及INH-A水平与血hCG转阴时间呈正相关(P<0.05)。结论VEGF、INH-A与患者血hCG转阴时间密切相关,VEGF水平上升、INH-A水平下降为hCG转阴时间延长的危险因素,可作为临床判断患者预后的有效检测指标。

Objective To investigate correlation of vascular endothelial growth factor(VEGF)and inhibin A(INH-A)with the blood human chorionic gonadotropin(hCG)negative conversion time in patients with gestational trophoblastic neoplasia(GTN).Methods Eighty-seven GTN patients in People's Hospital of Dazu District from April 2019 to September 2022 were retrospectively enrolled.The clinical data of patients were collected.Serum VEGF,INH-A and hCG levels were detected before treatment,and the hCG negative conversion time was also recorded.Logistic regression analysis was performed to screen the risk factors affecting the hCG negative conversion time,and Pearson's correlation analysis was conducted to verify the correlation between serum VEGF and INH-A levels and time to hCG conversion.Results The pre-treatment VEGF,INH-A and hCG levels were(342.16±93.25)pg/mL,(9.51±4.36)pg/mL and(1745.32±451.37)IU/L.The hCG negative conversion time ranged from 8 to 248 d,with an average of(64.58±10.16)d.There was no statistically significant difference between the nature of the previous pregnancy,the time from the end of the previous pregnancy and the time of hCG turning negative(P>0.05).The time of hCG turning negative in patients with age≥40 years old,hCG level≥10000 IU/L before treatment,FIGO score≥13 points,VEGF level rising,INH-A level falling were significantly higher than those in patients with age<40 years old,hCG level<10000 IU/L before treatment,FIGO score<5 points,VEGF normal,INH-A level normal,the differences were statistically significant(P<0.05).Logistic regression analysis showed that hCG≥10000 IU/L,FIGO score≥5 points,increased VEGF level and decreased INH-A level were the influencing factors for the prolonged time of hCG turning negative(OR=2.431,95%CI:1.532-3.855;OR=1.022,95%CI:1.004-1.040;OR=1.041,95%CI:1.016-1.066;OR=2.156,95%CI:1.431-3.247;P<0.05).Pearson correlation analysis showed VEGF and INH-A levels were positively correlated with the hCG negative conversion time(P<0.05).Conclusion Serum levels of VEGF and INH-A in GTN women are closely related to the hCG negative conversion time.Furthermore,elevated VEGF level and decreased INH-A level are risk factors for the prolonged time of hCG turning negative,so the two indicators can be used as effective indicators for clinical judgment of patients'prognosis.