肿瘤标志物、PTTG、VEGFR-3及血流参数在宫颈病变中的价值
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摘要
目的探讨肿瘤标志物、垂体瘤转化基因(PTTG)、血管内皮生长因子受体3(VEGFR-3)及血流动力学指标在宫颈良恶性病变患者中的表达及临床意义。方法选取2012年3月-2016年2月该院收治且经病理确诊的98例宫颈病变患者的临床资料。所有患者术中均留取宫颈组织标本,入院后均采集血样,采用免疫组织化学法测定PPTG、VEGFR-3表达情况,并测定血清鳞状细胞癌抗原(SCC)、糖类抗原19-9(CA199)、糖类抗原125(CA125)水平,检测微血管密度(MVD)。采用多普勒超声测定收缩期峰值血流速度(PSV)、舒张末血流速度(EDV)及血管阻力指数(RI),分析宫颈良恶性病变患者上述指标的表达情况及临床意义。结果 (1)慢性宫颈炎患者SCC、CA199及CA125水平均低于宫颈上皮内瘤样病变(CIN)患者与宫颈浸润癌患者(P <0.05),CIN患者上述水平低于宫颈浸润癌患者(P<0.05);(2) CIN、宫颈浸润癌PTTG、VEGFR-3表达阳性率高于慢性宫颈炎(P <0.05),宫颈浸润癌PTTG、VEGFR-3表达阳性率高于CIN(P <0.05);(3)慢性宫颈炎MVD低于CIN、宫颈浸润癌(P <0.05),CIN MVD低于宫颈浸润癌(P <0.05);(4) CIN、宫颈浸润癌PSV、EDV均高于慢性宫颈炎(P <0.05),RI低于慢性宫颈炎(P <0.05),宫颈浸润癌PSV、EDV高于CIN,RI低于CIN(P <0.05)。结论宫颈浸润癌患者血清肿瘤标志物表达水平高,癌组织PTTG、VEGFR阳性率高、MVD高,血流速度快、血管阻力低,与宫颈良性病变患者有差异。
Objective To investigate the expression and clinical significance of tumor markers, pituitary tumor transforming gene(PTTG), vascular endothelial growth factor receptor-3(VEGFR-3) and hemodynamic indexes in patients with benign or malignant cervical lesions. Methods Totally 98 patients with pathologically confirmed cervical lesions were admitted into our hospital from March 2012 to February 2016 and were involved in this study. Cervical tissuesand blood samples of all patients were collected. The expressions of PPTG and VEGFR-3 were determined by Immunohistochemistry. Levels of serum squamous cell carcinoma antigen(SCC), carbohydrate antigen 19-9(CA199), carbohydrate antigen 125(CA125), microvessel density(MVD), peak systolic velocity(PSV), end diastolic velocity(EDV) and vascular resistance index(RI) were identified. Clinical significance of above-mentioned indexes in patients with benign or malignant lesions were analyzed. Results Levels of SCC, CA199 and CA125 in patients with cervical intraepithelial neoplasia(CIN) were increased compared with those in patients with chronic cervicitis(P < 0.05),while those were downregulated when compared with patients with invasive cervical carcinoma(P < 0.05). The positive expression rates of PTTG and VEGFR-3 in patients with cervical intraepithelial neoplasia(CIN) were increased compared with those in patients with chronic cervicitis(P < 0.05), while those were downregulated when compared with patients with invasive cervical carcinoma(P < 0.05).MVD, PSV and EDV in patients with cervical intraepithelial neoplasia(CIN) were upregulated comparedwith those in patients with chronic cervicitis(P < 0.05), while those were decreased when compared with patients with invasive cervical carcinoma(P < 0.05). However, RI decreased in patients with CIN when compared with patients with chronic cervicitis(P < 0.05), while that was increased when compared with patients with invasive cervical carcinoma. Conclusion Patients with invasive cervical carcinoma experience increased levels of serum cancer markers, positive rates of PTTG and VEGFR, MVD, fast blood flow and decreased vascular resistance, which may be potential prognostic biomarkers.
Objective To investigate the expression and clinical significance of tumor markers, pituitary tumor transforming gene(PTTG), vascular endothelial growth factor receptor-3(VEGFR-3) and hemodynamic indexes in patients with benign or malignant cervical lesions. Methods Totally 98 patients with pathologically confirmed cervical lesions were admitted into our hospital from March 2012 to February 2016 and were involved in this study. Cervical tissuesand blood samples of all patients were collected. The expressions of PPTG and VEGFR-3 were determined by Immunohistochemistry. Levels of serum squamous cell carcinoma antigen(SCC), carbohydrate antigen 19-9(CA199), carbohydrate antigen 125(CA125), microvessel density(MVD), peak systolic velocity(PSV), end diastolic velocity(EDV) and vascular resistance index(RI) were identified. Clinical significance of above-mentioned indexes in patients with benign or malignant lesions were analyzed. Results Levels of SCC, CA199 and CA125 in patients with cervical intraepithelial neoplasia(CIN) were increased compared with those in patients with chronic cervicitis(P < 0.05),while those were downregulated when compared with patients with invasive cervical carcinoma(P < 0.05). The positive expression rates of PTTG and VEGFR-3 in patients with cervical intraepithelial neoplasia(CIN) were increased compared with those in patients with chronic cervicitis(P < 0.05), while those were downregulated when compared with patients with invasive cervical carcinoma(P < 0.05).MVD, PSV and EDV in patients with cervical intraepithelial neoplasia(CIN) were upregulated comparedwith those in patients with chronic cervicitis(P < 0.05), while those were decreased when compared with patients with invasive cervical carcinoma(P < 0.05). However, RI decreased in patients with CIN when compared with patients with chronic cervicitis(P < 0.05), while that was increased when compared with patients with invasive cervical carcinoma. Conclusion Patients with invasive cervical carcinoma experience increased levels of serum cancer markers, positive rates of PTTG and VEGFR, MVD, fast blood flow and decreased vascular resistance, which may be potential prognostic biomarkers.
引文
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[11]张程玲,李金科,张程珑,等.分化抑制因子Id-1与VEGF及MVD在宫颈癌变中的相关性分析[J].现代妇产科进展,2013,22(1):10-12.
[12]MéMIN E,HOQUE M,JAIN M R,et al.Blocking eIF5Amodification in cervical cancer cells alters the expression of cancer-related genes and suppresses cell proliferation[J].Cancer Research,2014,74(2):552-562.
[13]DANG Y Z,ZHANG Y,LI J P,et al.High VEGFR1/2 expression levels are predictors of poor survival in patients with cervical cancer[J].Medicine,2017,96(1):e5772.
[14]张红平,余晶,杨宏英,等.OPN、VEGF-C在早期宫颈癌中的表达[J].现代预防医学,2012,39(3):577-580.
[15]杨杰,张泽高,阿依古丽·依不拉音木,等.血清VEGF水平对中晚期宫颈癌诊断价值及同期放化疗疗效影响研究[J].中华放射肿瘤学杂志,2013,22(2):99-101.
[16]陈晓露,张波,吴蓉宜.CK2β、VEGF和p53蛋白表达对宫颈癌患者预后的预测价值研究[J].重庆医学,2016,45(8):1083-1086.
[17]蒙玉刚,梁春燕,曾雅畅,等.血管内皮生长因子C和D在宫颈癌中的表达及其与淋巴转移关系[J].重庆医学,2013,42(18):2076-2079.
[18]李龙.宫颈癌组织中真核细胞翻译起始因子4E和血管内皮生长因子的表达及意义[J].广东医学,2015,36(13):2060-2063.
[2]铁炜炜,葛芬芬.宫颈癌及癌前病变患者高危型HPV16感染与HLA-I表达的关系[J].中国现代医生,2017,55(12):66-69.
[3]卢丹,钱静,孙飞,等.PI3K、Akt、mTOR、p70S6K基因在宫颈癌变过程中的表达及相关性研究[J].中国现代医学杂志,2015,25(2):46-51.
[4]闵玲,钟亮星,陈琳娜,等.血清TSGF、SCC联合检测在宫颈癌诊断中的应用价值[J].实用医学杂志,2014,30(6):898-900.
[5]车玉传,苏运钦,温旺荣,等.miR-155-5p在宫颈癌血清中的表达及其对宫颈癌细胞的影响[J].中国病理生理杂志,2013,29(12):2193-2200.
[6]TANGKA F K,HOWARD D H,ROYALTY J,et al.Cervical cancer screening of underserved women in the United States:results from the national breast and cervical cancer early detection program,1997-2012[J].Cancer Causes&Control,2015,26(5):671-686.
[7]VIIKKI M,PUKKALA E,HAKAMA M.Risk of cervical cancer subsequent to a positive screening cytology:follow‐up study in Finland[J].Acta Obstetricia Et Gynecologica Scandinavica,2015,79(7):576-579.
[8]HERFS M,CRUM C P.Cervical cancer:squamocolumnar junction ablation[mdash]tying up loose ends[J].Nature Reviews Clinical Oncology,2015,12(7):378-380.
[9]梁指荣,杨洁飞,苏锡康.多种肿瘤标记物检测在宫颈癌诊治中的意义[J].医学临床研究,2016,33(9):21-23.
[10]SATO A,ISHIWATA T,MATSUDA Y,et al.Expression and role of nestin in human cervical intraepithelial neoplasia,and cervical cancer[J].International Journal of Oncology,2012,41(2):441-448.
[11]张程玲,李金科,张程珑,等.分化抑制因子Id-1与VEGF及MVD在宫颈癌变中的相关性分析[J].现代妇产科进展,2013,22(1):10-12.
[12]MéMIN E,HOQUE M,JAIN M R,et al.Blocking eIF5Amodification in cervical cancer cells alters the expression of cancer-related genes and suppresses cell proliferation[J].Cancer Research,2014,74(2):552-562.
[13]DANG Y Z,ZHANG Y,LI J P,et al.High VEGFR1/2 expression levels are predictors of poor survival in patients with cervical cancer[J].Medicine,2017,96(1):e5772.
[14]张红平,余晶,杨宏英,等.OPN、VEGF-C在早期宫颈癌中的表达[J].现代预防医学,2012,39(3):577-580.
[15]杨杰,张泽高,阿依古丽·依不拉音木,等.血清VEGF水平对中晚期宫颈癌诊断价值及同期放化疗疗效影响研究[J].中华放射肿瘤学杂志,2013,22(2):99-101.
[16]陈晓露,张波,吴蓉宜.CK2β、VEGF和p53蛋白表达对宫颈癌患者预后的预测价值研究[J].重庆医学,2016,45(8):1083-1086.
[17]蒙玉刚,梁春燕,曾雅畅,等.血管内皮生长因子C和D在宫颈癌中的表达及其与淋巴转移关系[J].重庆医学,2013,42(18):2076-2079.
[18]李龙.宫颈癌组织中真核细胞翻译起始因子4E和血管内皮生长因子的表达及意义[J].广东医学,2015,36(13):2060-2063.