血管内皮生长因子C在宫颈癌及宫颈癌前病变患者血清的表达水平及临床意义

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FIGOIU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353．0ng／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。

The clinical research of the serum VEGF-C in cervical cancer and cervical lesions patients

Objective]To investigate the content of the vascular endothelial growth factor C （VEGF-C） in serum of cervical cancer and cervical lesions patients and its clinical effects. Methods ] The clinical data of 74 cases April 2010 - April 2013 in our hospital suspected to be with cervical cancer were collected and analyzed retrospectively.74 cases included 38 cases of cervical intraepithelial neoplasia Ⅱ / Ⅲ grade,18 cases of cervical cancer without lymph node metastasis and 18 eases of cervical lymph node metastasis, which were classified as A, B, C group. 74 cases of uterine fibroids were selected as normal control and were classified as the control groups. ELISA was used to detect the expression levels of VEGF-C in serum of 148 cases. The levels of VEGF-C expression of the four groups were compared and ROC curves were used to analyze the effect of VEGF-C about the probability of presence or absence of lymph node metastasis. Results ] The VEGF-C levels of Group C was significantly higher than the other three groups （P〈0.05）. The VEGF-C levels of Group B was higher than that of group A and the control group （P〈0.05）, while the VEGF-C levels of Croup A was higher than the control group＇ s （P〈0.05）.The VEGF-C levels of those with cervical carcinoma FICO Ⅲ grade was significantly higher than that in FIGO Ⅰ and Ⅱ （P〈0.05）, however, there was no significant difference between different degree of differentiation（P〉0.05）. ROC curve analysis showed serum VEGF-C reached a sensitivity of 84.0% and specificity of 83.5% when a cut-off value of 353.0ng/L was applied. Conclusion ] The VEGF-C level in the serum of patients with cervical cancer may be an useful biological marker to foresee the prognosis, which be of clinical significance.