子宫内膜癌患者VEGF、HE4、miR-93表达特征及检测价值研究

Expression characteristics and detection value of VEGF,HE4 and miR-93 in patients with endometrial carcinoma

目的探讨子宫内膜癌患者血管内皮生长因子(Vascular endothelial growth factor,VEGF)、人附睾蛋白4(Human epididymal protein 4,HE-4)、微小核糖核酸-93(Micrornas-93,miR-93)表达特征及检测价值。方法回顾性选取2021年3月-2022年6月新疆医科大学附属肿瘤医院妇外四科收治的53例子宫内膜癌患者的临床资料为研究组,选取同期收治的53例子宫肌瘤患者的临床资料为对照组。两组患者均于入院后抽取空腹静脉血,经荧光定量聚合酶链反应法测定miR-93水平,以电化学发光法测定血VEGF与HE4水平。对比研究组与对照组之间,不同病理分级、疾病分期、肌层浸润、淋巴结转移情况及不同预后患者miR-93、VEGF与HE4水平,分析miR-93、VEGF与HE4水平与子宫内膜癌疾病状况关联性,并比较miR-93、VEGF与HE4对子宫内膜癌预后的预测价值。结果与对照组比较,研究组miR-93、VEGF与HE4水平增高,差异有统计学意义(P<0.05)。不同病理分级、疾病分期、肌层浸润、淋巴结转移情况患者miR-93、VEGF与HE4水平差异有统计学意义(P<0.05),且随着病理分级和疾病分期的增高,肌层浸润程度增加,淋巴结转移、miR-93、VEGF与HE4水平增高,差异有统计学意义(P<0.05)。Pearson检验表明,miR-93、VEGF与HE4水平与子宫内膜癌病理分级、疾病分期、肌层浸润程度、淋巴结转移情况存在显著正相关关系(P<0.05)。预后不良者miR-93、VEGF与HE4水平高于预后良好者(P<0.05)。miR-93、VEGF与HE4联合检测预测子宫内膜癌预后的AUC、敏感度、特异度分别为0.952、84.20%、71.80%,优于单独检测预测效能。结论子宫内膜癌患者VEGF、HE4、miR-93均呈高表达状态,其增高幅度与疾病病理分级、疾病分期、肌层浸润、淋巴结转移情况存在密切相关性,对子宫内膜癌的预后预测具有较高的价值,临床可联合检测VEGF、HE4、miR-93对子宫内膜进行病情评估和预后预测。

Objective To investigate the expression characteristics and detection value ofvascular endothelial growth factor(VEGF),human epididymal protein 4(HE-4)andmicrornas-93(miR-93)in patients with endometrial cancer.MethodsThe clinical data of 53 patients with endometrial cancer admitted to the hospital from March 2021 to June 2022 were retrospectively selected as the study group,and the clinical data of 53 patients with uterine fibroids admitted during the same period were selected as the control group.Fasting venous blood was collected from the both groups after admission,and the levels of miR-93 were determined by fluorescence quantitative polymerase chain reaction,and the levels of VEGF and HE4 were determined by electroluminescence.The levels of miR-93,VEGF and HE4 were compared between the study group and the control groupin patients with different pathological grades,disease stages,muscular infiltration,lymph node metastasis and different prognosis,and the correlation between the levels of miR-93,VEGF and HE4 and the disease status of endometrial cancer were analyzed.The prognostic value of miR-93,VEGF and HE4 in endometrial carcinoma was compared.ResultsCompared with the control group,the levels of miR-93,VEGF and HE4 in the study group were increased,and the difference was statistically significant(P<0.05).There were significant differences in the levels of miR-93,VEGF and HE4 among the patients with different pathological grades,disease stages,muscle infiltration and lymph node metastasis(P<0.05),and the levels of miR-93,VEGF and HE4 were increased with the increase of pathological grades and disease stages,muscle infiltration degree and lymph node metastasis(P<0.05).Pearson test showed that miR-93,VEGF and HE4 levels were significantly positively correlated with the pathological grade,disease stage,degree of muscular infiltrationand lymph node metastasis of endometrial cancer(P<0.05).The levels of miR-93,VEGF and HE4 in patients with poor prognosis were higher than those in patients with good prognosis(P<0.05).The AUC,sensitivity and specificity of the combined detection of miR-93,VEGF and HE4 in predicting the prognosis of endometrial carcinoma was 0.952,84.20%and 71.80%,respectively,which was better than the prediction of the single detection.ConclusionVEGF,HE4,and miR-93 are highly expressed in patients with endometrial cancer,and their increasesare closely related to diseasepathological grade,disease stage,myometrial infiltrationand lymph node metastasis,which hasahigh value in predicting the prognosis of endometrial cancer.Clinically,VEGF,HE4,and miR-93 can be jointly detected for diseaseassessment and prognosisprediction.