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目的:研究鳞状细胞相关抗原(Scc-Ag)和血管内皮生长因子(VEGF)在宫颈浸润癌新辅助化疗前、后水平的改变,探讨其在宫颈浸润癌诊断和新辅助化疗疗效观察中的临床意义。方法:分别采用化学发光检测技术和酶联免疫(ELISA)法测定89例宫颈浸润癌患者新辅助化疗前后Scc-Ag和VEGF水平,并进行对比分析和观察。结果:①89例宫颈浸润癌患者新辅助化疗前Scc-Ag和VEGF的中位值水平分别为13.61μg/L和393.75μg/L,阳性率为60.67%(54/89)和73.03%(65/89);新辅助化疗后Scc-Ag和VEGF的中位值水平分别为7.59μg/L和286.37μg/L,阳性率为51.68%(46/89)和65.16%(58/89)。新辅助化疗前、后比较中位值水平差异有统计学意义(P<0.05),阳性率差异无统计学意义(P>0.05)。②宫颈浸润癌患者新辅助化疗后的总反应率为83.15%(74/89),可手术率为77.52%(69/89),化疗无反应率为22.47%(20/89),4例患者新辅助化疗后Scc-Ag和VEGF水平恢复正常;但有10例患者Scc-Ag和VEGF水平较新辅助化疗前增高更为显著(P<0.05),且皆为对化疗无反应的手术困难病例。结论:Scc-Ag和VEGF是诊断宫颈浸润癌较为灵敏的指标,接受新辅助化疗后,部分患者Scc-Ag和VEGF恢复到正常水平,少数患者Scc-Ag和VEGF水平增高更明显,且皆为对化疗无反应的手术困难病例,预后差。因此,Scc-Ag和VEGF是宫颈浸润癌较敏感的实验观察指标,在宫颈浸润癌诊断和新辅助化疗疗效观察中有一定的临床应用价值。
Objective: To study the changes of Scc-Ag and VEGF in cervical precancerous neoplasms before and after neoadjuvant chemotherapy, and to investigate the changes of Scc-Ag and VEGF in the diagnosis of cervical invasive carcinoma and neoadjuvant chemotherapy Clinical significance. Methods: The levels of Scc-Ag and VEGF in 89 patients with cervical invasive carcinoma before and after neoadjuvant chemotherapy were determined by chemiluminescence detection and enzyme-linked immunosorbent assay respectively. Results: The median levels of Scc-Ag and VEGF before neoadjuvant chemotherapy in 89 patients with cervical invasive carcinoma were 13.61μg / L and 393.75μg / L respectively, the positive rates were 60.67% (54/89) and 73.03% (65 / 89). The median levels of Scc-Ag and VEGF after neoadjuvant chemotherapy were 7.59μg / L and 286.37μg / L, respectively. The positive rates were 51.68% (46/89) and 65.16% (58/89) respectively. Neoadjuvant chemotherapy before and after the comparison of median level difference was statistically significant (P <0.05), the positive rate difference was not statistically significant (P> 0.05). ② The total response rate after neoadjuvant chemotherapy in patients with cervical invasive carcinoma was 83.15% (74/89), the operative rate was 77.52% (69/89), the non-response rate was 22.47% (20/89) in chemotherapy and 4 patients The levels of Scc-Ag and VEGF returned to normal after neoadjuvant chemotherapy; however, the levels of Scc-Ag and VEGF in 10 patients were significantly higher than those before neoadjuvant chemotherapy (P <0.05), and all of them were difficult cases of surgery that did not respond to chemotherapy . Conclusion: Scc-Ag and VEGF are more sensitive indicators for the diagnosis of invasive cervical cancer. After neoadjuvant chemotherapy, the levels of Scc-Ag and VEGF in some patients returned to normal level. Scc-Ag and VEGF levels increased significantly in a few patients, both of which were Poor response to chemotherapy surgery cases, the prognosis is poor. Therefore, Scc-Ag and VEGF are more sensitive experimental indicators of invasive cervical cancer, cervical invasive carcinoma in the diagnosis and efficacy of neoadjuvant chemotherapy has some clinical value.