血管内皮生长因子在宫颈鳞癌介入化疗前后的表达比较

【目的】探讨血管内皮生长因子（VEGF）在宫颈鳞癌发生发展中的作用，观察介入化疗前后的VEGF表达并进一步评价术前介入化疗联合根治术治疗宫颈鳞癌的可行性和有效性。【方法】采用免疫组化的方法对20例宫颈鳞癌，30例宫颈上皮内瘤样病变及20例正常宫颈组织进行VEGF检测。【结果】宫颈鳞癌VEGF阳性表达率（70％）明显高于宫颈上皮内瘤样病变（CIN）（20％）及正常宫颈组织（5％），差异有显著性（P〈0．01）。宫颈鳞癌VEGF表达与肿瘤转秽、临床分期及组织学分级无明显相关性（P〉0．05）。宫颈鳞癌介入化疗前VEGF阳性表达水平以高表达为主，而介入化疗后VEGF阳性表达以低表达为主．差异有显著性（P〈0．05）。本组20例宫颈鳞癌患者均行根治性手术，介入化疗后有效率为95％，手术切除率达100％，术后4例患者有淋巴结转移。阴道残端切缘无癌细胞。20例患者均未发生严重介入化疗和手术相关的并发症。【结论】VEGF在宫颈鳞癌组织中呈高表达，从血管生成方面进一步阐述宫颈鳞癌的发生发展，可作为宫颈鳞癌的一种肿瘤指标。术前介入化疗可缩小肿瘤病灶，减少淋巴结转移，且组织中VEGF在宫颈癌介入化疗前后差异有显著性，故认为介入化疗是宫颈鳞癌有效的具有可行性的辅助治疗手段。

Different Expressions of Vascular Endothelial Growth Factor Before and After Interventional Chemotherapy in Patients with Cervical Squamous Carcinoma

Objective]To study the effect of vascular endothelial growth factor(VEGF) in occurrence and development of cervical squamous carcinoma and the difference of expression of VEGF before and after intra-arterial chemotherapy , evaluate the feasibility and efficacy of intra-arterial chemotherapy followed by radical hysterectomy of cervical squamous carcinoma.Methods]Twenty cases of cervical squamous carcinoma,30 cases of cervical intraepithelial neoplasia(CIN)and 20 cases of normal cervical tissue sample were stained for VEGF by immunohistochemistry method.Results]VEGF positive expression rate in cervical squamous carcinoma(70%) was significantly higher than that in normal cervical tissue(5%)and CIN(20%)(P<0.01). VEGF expression was not correlated to metastasis,the clinical stage of the tumor and the grade of histology. VEGF positive expression level in cervical squamous carcinoma before intra-arterial chemotherapy was significantly higher than that after radical hysterectomy(P<0.05). All patients of cervical squamous carcinoma underwent radical hysterectomy. The total response rate was 95%.The radical hysterectomy rate was 100%,4 patients had pelvic lymph node metastasis(20%). There were no severe complications related to intra-arterial chemotherapy and radical hysterectomy.Conclusion]VEGF may be a marker of cervical squamous carcinoma . Intar-arterial chemotherapy before operation can shrink tumor size,decrease the lymph node mestastasis. So intra-arterial chemotherapy before operation is a feasible and efficacious assistant method with the difference of expression of VEGF before intra-arterial chemotherapy and after operation for cervical squamous carcinoma.