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目的:研究血清中血管内皮生长因子(VEGF)在早期宫颈癌诊断方面的价值。方法:以47例妇科良性肿瘤患者、16例宫颈炎患者及30例正常女性作对照,采用ELISA法测定了160例早期宫颈癌患者血清中VEGF的含量,其中144例早期宫颈癌患者做了术前、术后的对比测定。13例患者复发后测定VEGF值与术后VEGF值对比测定。结果:早期宫颈癌患者血清VEGF值显著高于妇科良性肿瘤、宫颈炎患者和健康女性(P均<0.002),其诊断早期宫颈癌的敏感性为43.3 %,特异性为96.7 %,妇科良性肿瘤及宫颈炎的假阳性率分别为6.4 %及12.5 %;血清VEGF水平与肿瘤负荷相关,Ⅱ期宫颈癌及肿瘤直径>4 cm的患者明显高于Ⅰ期宫颈癌及直径<4 cm者,但与病理分级及淋巴结是否转移关系不大;术后绝大多数患者血清VEGF有一过性上升,明显高于术前,2 个月~ 3个月后开始下降,低于术前水平;宫颈癌术后复发患者血清VEGF值呈上升趋势,与术后2个月的血清VEGF值比较,P<0.05。结论:血清VEGF诊断早期宫颈癌的敏感性并不高,但对于鉴别宫颈炎与癌症,评价分期与宫颈癌体积的大小有一定的帮助。患者术后VEGF值曾一度降低,如再一次升高可能是复发的一个信号。
Objective: To study the value of serum vascular endothelial growth factor (VEGF) in the diagnosis of early cervical cancer. Methods: 47 cases of gynecological benign tumor patients, 16 cases of cervicitis patients and 30 normal women as control, the ELISA method was used to determine the serum levels of VEGF in 160 cases of early cervical cancer patients, of which 144 cases of early cervical cancer surgery Before and after contrast test. Thirteen patients with relapsed after the determination of VEGF value and postoperative VEGF value comparison test. Results: The serum VEGF of patients with early cervical cancer was significantly higher than that of patients with benign gynecological tumors, cervicitis and healthy women (all P <0.002). The sensitivity and specificity of diagnosing early cervical cancer were 43.3% and 96.7% And cervicitis were 6.4% and 12.5%, respectively. Serum VEGF levels were correlated with tumor burden. Stage II cervical cancer and tumor diameter> 4 cm were significantly higher than those with stage I cervical cancer and diameter <4 cm There was no significant correlation between pathological grade and lymph node metastasis. Serum VEGF increased transiently in the vast majority of postoperative patients, which was significantly higher than that before operation and began to decline after 2 months to 3 months, lower than preoperative level. Serum VEGF levels in post-relapse patients showed an upward trend, compared with serum VEGF values at 2 months postoperatively (P <0.05). Conclusions: The sensitivity of serum VEGF in diagnosing early stage cervical cancer is not high. However, it is helpful to evaluate the stage and size of cervical cancer for the differential diagnosis of cervicitis and cancer. Patients with postoperative VEGF values once decreased, such as the rise may be a sign of recurrence.