鳞状细胞相关抗原和血管内液生长因子在宫颈浸润癌新辅助化疗前后的改变及临床意义

目的：研究鳞状细胞相关抗原（Scc-Ag）和血管内皮生长因子（VEGF）在宫颈浸润癌新辅助化疗前、后水平的改变,探讨其在宫颈浸润癌诊断和新辅助化疗疗效观察中的临床意义。方法：分别采用化学发光检测技术和酶联免疫（ELISA）法测定89例宫颈浸润癌患者新辅助化疗前后Scc-Ag和VEGF水平,并进行对比分析和观察。结果：①89例宫颈浸润癌患者新辅助化疗前Scc-Ag和VEGF的中位值水平分别为13.61μg/L和393.75μg/L,阳性率为60.67%（54/89）和73.03%（65/89）;新辅助化疗后Scc-Ag和VEGF的中位值水平分别为7.59μg/L和286.37μg/L,阳性率为51.68%（46/89）和65.16%（58/89）。新辅助化疗前、后比较中位值水平差异有统计学意义（P〈0.05）,阳性率差异无统计学意义（P〉0.05）。②宫颈浸润癌患者新辅助化疗后的总反应率为83.15%（74/89）,可手术率为77.52%（69/89）,化疗无反应率为22.47%（20/89）,4例患者新辅助化疗后Scc-Ag和VEGF水平恢复正常;但有10例患者Scc-Ag和VEGF水平较新辅助化疗前增高更为显著（P〈0.05）,且皆为对化疗无反应的手术困难病例。结论：Scc-Ag和VEGF是诊断宫颈浸润癌较为灵敏的指标,接受新辅助化疗后,部分患者Scc-Ag和VEGF恢复到正常水平,少数患者Scc-Ag和VEGF水平增高更明显,且皆为对化疗无反应的手术困难病例,预后差。因此,Scc-Ag和VEGF是宫颈浸润癌较敏感的实验观察指标,在宫颈浸润癌诊断和新辅助化疗疗效观察中有一定的临床应用价值。

Changes and clinical significance of tumor markers Scc-Ag and VEGF expression in invasive cervical carcinoma pre and post neoadjuvant chemotherapy

Objective：To study the changes of squamous cell carcinoma-associated antigen （Scc-Ag） and vascular endothelial growth factor （VEGF） in invasive cervical carcinoma pre and post neoadjuvant chemotherapy,and explore its clinical significance in the diagnosis and efficacy observation of neoadjuvant chemotherapy in invasive cervical carcinoma. Method：The Scc-Ag and VEGF levels of 89 patients with invasive cervical carcinoma pre and post neoadjuvant chemotherapy were detected by chemiluminescence immunoassay and enzyme-linked immunosorbent assay （ELISA）,respectively,and compared. Result：①The median levels of Scc-Ag and VEGF of 89 invasive cervical carcinoma patients pre neoadjuvant chemotherapy were 13.61 μg/L and 393.75 μg/L,respectively; and the positive rates were 60.67% （54/89） and 73.03% （65/89）,respectively. The median levels of Scc-Ag and VEGF post neoadjuvant chemotherapy were 7.59 μg/L and 286.37 μg/L,respectively; and the positive rates were 51.68% （46/89） and 65.16% （58/89）,respectively. There were significant differences of the median levels of Scc-Ag and VEGF between pre and post neoadjuvant chemotherapy （P0.05）,while there were no significant differences of positive rates（P 0. 05）. ②After neoadjuvant chemotherapy,the total response rate of patients with invasive cervical carcinoma was 83.15% （74/89）,operation rate was 77.52% （69/89）,and non-response rate for chemotherapy was 22.47% （20/89）. The Scc-Ag and VEGF levels of 4 patients returned to normal after neoadjuvant chemotherapy. However,the Scc-Ag and VEGF levels of 10 patients increased more significantly（P0.05）,who all had no response to chemotherapy and difficult to surgery. Conclusion：Scc-Ag and VEGF would be more sensitive indicators in the diagnosis of invasive cervical carcinoma. After neoadjuvant chemotherapy,the Scc-Ag and VEGF levels of some patients returned to normal,and a small number increased more obviously who all had no response to chemotherapy and difficult to surgery with poor prognosis. Thus,Scc-Ag and VEGF could be more sensitive indicators of experimental observation of invasive cervical carcinoma which have certain clinical significance in the diagnosis and clinical observation of neoadjuvant chemotherapy of invasive cervical carcinoma.