术前血清miR-221-3p及血管内皮生长因子-C表达与早期宫颈鳞癌发生盆腔淋巴结转移的关系  

Relationships of preoperative serum miR-221-3p and vascular endothelial growth factor-C with pelvic lymph node metastasis in patients with early cervical squamous cell carcinoma

作　　者：徐敏芹 李雪[1] 周玲[1] 张弘[1] 张书筠 高爱华[1] XU Min-qin;LI Xue;ZHOU Ling;ZHANG Hong;ZHANG Shu-yun;GAO Ai-hua(Department of Obstetrics and Gynecology the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第二医院妇产科,江苏苏州215000

出　　处：《中华实用诊断与治疗杂志》2022年第1期18-21,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：江苏省卫生计生委医学科研课题(Z2017008);江苏省妇幼健康科研项目(F201757)。

摘　　要：目的观察早期宫颈鳞癌患者术前血清miR-221-3p表达及血管内皮生长因子-C(vascular endothelial growth factor-C, VEGF-C)水平变化,探讨其与早期宫颈鳞癌盆腔淋巴结转移的关系。方法经手术组织病理证实的宫颈鳞癌患者214例,发生盆腔淋巴结转移48例为转移组,未发生盆腔淋巴结转移166例为未转移组;同期宫颈良性疾病患者60例为对照组。2组于入院次日采集血液标本,采用实时荧光定量PCR法检测血清miR-221-3p相对表达量,采用ELISA法检测血清VEGF-C水平;Pearson相关法分析早期宫颈鳞癌患者术前血清miR-221-3p表达与VEGF-C水平的相关性;比较转移组与未转移组临床病理特征及术前血清miR-221-3p相对表达量、VEGF-C水平;多因素logistic回归分析早期宫颈鳞癌患者发生盆腔淋巴结转移的影响因素;绘制ROC曲线,评估术前血清miR-221-3p、VEGF-C预测早期宫颈鳞癌患者发生盆腔淋巴结转移的价值。结果宫颈鳞癌组术前血清miR-221-3p相对表达量(3.96±1.01)、VEGF-C水平[(41.18±9.55) ng/L]均高于对照组[1.41±0.38、(25.06±6.63) ng/L](t=33.514,P<0.001;t=19.818,P<0.001)。早期宫颈鳞癌患者术前血清miR-221-3p相对表达量与VEGF-C水平呈正相关(r=0.552,P<0.001)。转移组肿瘤直径≥4 cm比率(12.50%)、FIGO分期ⅡA1~ⅡA2期比率(33.33%)、浸润深度≥2/3比率(95.83%)及术前血清miR-221-3p相对表达量(4.76±0.64)、VEGF-C水平[(49.07±9.01)ng/L]均高于未转移组[4.22%、18.07%、81.33%、3.73±0.98、(38.90±8.45)ng/L](P<0.05)。浸润深度≥2/3(OR=1.131,95%CI:1.068~1.322,P=0.040)及术前血清miR-221-3p(OR=2.475,95%CI:1.472~4.164,P=0.001)、VEGF-C(OR=1.099,95%CI:1.041~1.160,P=0.001)是早期宫颈鳞癌患者发生盆腔淋巴结转移的影响因素。术前血清miR-221-3p、VEGF-C分别以4.03、49.25 ng/L为最佳截断值,单独及联合预测早期宫颈鳞癌患者发生盆腔淋巴结转移的AUC分别为0.812(95%CI:0.753~0.862,P<0.001)、0.804(95%CI:0.744~0.855,P<0.00Objective To observe the preoperative expression of miR-221-3 p and the level of vascular endothelial growth factor-C(VEGF-C) in patients with early cervical squamous cell carcinoma, and to explore their relationships with pelvic lymph node metastasis. Methods Totally 214 patients with histopathologically confirmed cervical squamous cell carcinoma were divided into 48 patients with pelvic lymph node metastasis(metastasis group) and 166 patients without pelvic lymph node metastasis(no-metastasis group). Another 60 patients with benign cervical diseases were as controls(control group). The blood samples were obtained on the second day after admission. The relative expression of serum miR-221-3 p and the level of VEGF-C were detected by real-time fluorescence quantitative PCR and ELISA, respectively. Pearson correlation analysis was used to assess the correlation between preoperative serum miR-221-3 p and VEGF-C in patients with early cervical squamous cell carcinoma. The pathological features, the preoperative relative expression of miR-221-3 p and the level of VEGF-C were compared between metastasis group and no-metastasis group. Multivariate logistic regression analysis was used to evaluate the influencing factors of pelvic lymph node metastasis in patients with early cervical squamous cell carcinoma.ROC curve was drawn to evaluate the efficacies of preoperative serum miR-221-3 p and VEGF-C on predicting pelvic lymph node metastasis in patients with early cervical squamous cell carcinoma.Results The preoperative relative expression of serum miR-221-3 p and the level of VEGF-C were higher in patients with cervical squamous cell carcinoma[3.96±1.01,(41.18±9.55)ng/L]than those in control group[1.41±0.38,(25.06±6.63)ng/L](t=33.514,P<0.001;t=19.818,P<0.001).The preoperative relative expression of serum miR-221-3 p in patients with early cervical squamous cell carcinoma was positively correlated with the level of VEGF-C(r=0.552,P<0.001).The percentages of tumor diameter ≥4 cm(12.50%),FIGO stage ⅡA1-A2(33.33%)an

关 键 词：宫颈鳞癌 盆腔 淋巴结转移 miR-221-3p 血管内皮生长因子-C 

分 类 号：R737.33[医药卫生—肿瘤]