血清CTGF在宫颈癌患者手术前后的变化及其预后判断价值

目的 探讨宫颈癌患者手术前后血清结缔组织生长因子(CTGF)水平变化及其预后判断价值.方法 选择2013年1月至2015年12月收治的宫颈癌患者48例、宫颈上皮内瘤样病变(CIN)患者30例和20例健康体检者作为研究对象,采用ELISA法检测血清CTGF水平,并分析血清CTGF水平及与宫颈癌临床病理特征及预后的关系.结果 宫颈癌患者手术前血清CTGF水平明显高于CIN和正常对照组(均P＜ 0.01),术后血清CTGF水平较术前明显升高(P＜0.01).术前血清CTGF水平与肿瘤大小、FIGO分期、淋巴结转移有关(P＜0.05);根据术后血清CTGF中位数水平,分为低水平CTGF(＜17.6ng/ml)和高水平CTGF(≥17.6 ng/ml),经Kaplan-Meier分析结果显示,术后血清CTGF高水平的患者生存时间显著长于血清CTGF低水平患者(x2=4.036,P=0.045);COX回归分析显示,影响宫颈癌预后的主要因素为FIGO分期、淋巴结转移和术后低水平CTGF(＜17.60 ng/ml).结论 宫颈癌患者血清CTGF水平降低,与宫颈癌的侵袭转移有关,检测术后血清CTGF含量变化对于宫颈癌患者的预后判断有较好的临床应用价值.

Prognostic evaluation value and changes of serum connective tissue growth factor before and after operation in cervical cancer patients

Objective To explore the changes of serum connective tissue growth factor (CTGF) level before and after operation in cervical cancer patients and the clinical prognostic evaluation value.Methods A total of 48 patients with cervical cancer,30 patients with cervical intraepithelial neoplasia (CIN),and 20 healthy controls were selected as the research object from January 2013 to December 2015.The level of serum CTGF was detected by enzyme-linked immunosorbent assay (ELISA).The relationship between serum CTGF level and clinical pathological features and prognosis of cervical cancer were analyzed.Results The level of serum CTGF in cervical cancer patients before operation was significantly higher than those in patients with CIN and healthy controls (all P＜0.01).The level of serum CTGF in cervical cancer patients after operation was significantly higher than that before operation (P＜0.01).The level of serum CTGF in cervical cancer patients before operation was closely related to tumor size,FIGO stage,and lymph node metastasis (P＜0.05).According to the postoperative CTGF median value,cervical cancer patients were divided into low CTGF group (＜17.6 ng/ml) and high CTGF group (＞17.6ng/ml);Kaplan-Meier analysis showed that the survival time of high CTGF group was longer than that of low CTGF group (x 2=4.036,P=0.045).COX regression model showed that FIGO stage,lymph node metastasis,and the low level of postoperative serum CTGF (＜17.60 ng/ml) were major influencing factors of the prognosis of cervical cancer.Conclusions The level of serum CTGF in cervical cancer patients decreased obviously,which was closely related to invasion and metastasis of cancer.It is valuable to detect postoperative changes of serum CTGF for judging the prognosis of patients with cervical cancer.