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目的探讨血管内皮生长因子C(VEGF-C)在宫颈癌、宫颈癌前病变患者血清的表达水平及临床意义。方法收集并回顾性分析2010年4月-2013年4月于武汉市江夏区第一人民医院门诊疑诊为宫颈癌的74例患者的临床资料,其中手术后病检结果为宫颈上皮内瘤变Ⅱ/Ⅲ级38例,宫颈癌不伴淋巴结转移18例,宫颈癌伴淋巴结转移18例,分别归为A、B、C组;同时选取74例同期子宫肌瘤患者为正常对照,归为对照组。采用酶联免疫吸附试验法检测148例研究对象血清中VEGF-C表达水平,并比较三组间的差异,采用ROC曲线探讨VEGF-C对宫颈癌淋巴结转移的预测价值。结果 C组的VEGF-C水平显著高于其他三组(P<0.05),B组VEGF-C水平较A组和对照组高(P<0.05),A组的VEGF-C水平显著高于对照组(P<0.05)。宫颈鳞癌FIGOⅢ期患者的血清VEGF-C水平显著高于Ⅰ期和Ⅱ期患者(P<0.05),但不同分化程度其血清VEGF-C水平无显著差异(P>0.05)。ROC曲线分析结果显示,当将VEGF-C诊断阈值设定为353.0 ng/L时,预测宫颈癌淋巴结转移的敏感度为84.0%,特异性为83.5%,VEGF-C曲线下面积为97.4%。结论对宫颈癌患者进行血清VEGF-C水平测定可初步预测宫颈癌预后,具有重要临床意义。
Objective To investigate the expression of vascular endothelial growth factor C (VEGF-C) in cervical cancer and cervical precancerous lesions and its clinical significance. Methods The clinical data of 74 patients suspected of cervical cancer from the First People’s Hospital of Jiangxia District in Wuhan from April 2010 to April 2013 were retrospectively collected and analyzed retrospectively. The results of postoperative pathological examination were cervical intraepithelial neoplasia Ⅱ / Ⅲ grade 38 cases, cervical cancer without lymph node metastasis in 18 cases, cervical cancer with lymph node metastasis in 18 cases, were classified as A, B, C group; the same time, select 74 cases of uterine fibroids in patients with normal control, grouped as control group. The serum levels of VEGF-C in 148 subjects were detected by enzyme linked immunosorbent assay (ELISA), and the differences among the three groups were compared. The ROC curve was used to investigate the predictive value of VEGF-C in lymph node metastasis of cervical cancer. Results The level of VEGF-C in group C was significantly higher than that in the other three groups (P <0.05). The level of VEGF-C in group B was higher than that in group A and control group (P <0.05) Group (P <0.05). Serum levels of VEGF-C in patients with FIGO Ⅲ cervical cancer were significantly higher than those in patients with stage I and II (P <0.05), but there was no significant difference in serum VEGF-C between patients with different grades of differentiation (P> 0.05). The results of ROC curve analysis showed that the sensitivity, specificity and accuracy of predicting the lymph node metastasis of cervical cancer were 84.0%, 83.5% and 97.4% respectively when the diagnostic threshold of VEGF-C was 353.0 ng / L. Conclusion Serum levels of VEGF-C in patients with cervical cancer can be used to predict the prognosis of cervical cancer, which has important clinical significance.