宫颈癌患者Th1/Th2漂移与微血管密度及术后复发的关系  

Correlation of Th1/Th2 balance driftwith microvascular densityand postoperative recurrence in patients with cervical cancer

作　　者：邓艳梅 刘玲玲 张勇 Deng Yanmei;Liu Lingling;Zhang Yong(Department of Obstetrics and Gynecolgy,Mianyang Central Hospital,School of Medicine,University of Electronic Scinece and Technology of China,Mianyang Sichuan 621000,P.R.China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院妇产科,四川绵阳621000

出　　处：《中国计划生育和妇产科》2023年第7期47-51,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的 研究宫颈癌患者Th1/Th2漂移与微血管密度(microvessel density, MVD)及术后复发的关系。方法 行前瞻性研究,选取电子科技大学医学院附属绵阳医院·绵阳市中心医院2017年1~12月期间收治的92例宫颈癌患者纳为宫颈癌组,同期门诊治疗的60例慢性宫颈炎患者纳为良性组,检测两组血清Th1细胞因子[白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)]及Th2细胞因子[白细胞介素-4(IL-4)、白细胞介素-6(IL-6)]水平,分别在术中采集宫颈癌组织、癌旁组织及宫颈炎性组织,标记CD34肿瘤新生血管,计算MVD计数。随访至2022年4月,统计宫颈癌术后复发率,分析宫颈癌不同病理特征及术后复发与患者血清Th1/Th2及MVD之间的关系。结果 宫颈癌组血清IL-2及IFN-γ水平低于良性组,IL-4及IL-6水平高于良性组,宫颈癌组织中MVD水平高于癌旁组织及炎性组织,差异均有统计学意义(P<0.05)。分析发现,临床分期>Ⅰb2期宫颈癌患者血清IL-4及癌灶组织内MVD表达水平均高于临床分期≤Ⅰb2期者,组织分化程度Ⅰ~Ⅱ级者MVD表达水平高于Ⅲ级者,原发肿瘤直径>4 cm者血清IL-6及MVD表达水平高于≤4 cm者,深肌层浸润者血清IL-2水平低于浅肌层浸润者,IL-6及MVD表达水平高于浅肌层浸润者,差异均有统计学意义(P<0.05)。宫颈癌术后复发者血清IL-2及IFN-γ水平低于未复发者,血清IL-4、IL-6及癌灶组织内MVD水平高于未复发者,差异均有统计学意义(P<0.05)。Person相关性分析提示,宫颈癌血清IFN-γ与MVD间呈负相关(r<0,P<0.05),IL-4及IL-6与MVD间呈正相关(r>0,P<0.05)。结论 宫颈癌患者存在Th1向Th2漂移现象,且Th1/Th2漂移可能促进癌灶内新生血管的生长,参与宫颈癌的发生发展及术后复发。Objective To analyze the correlation of T helper 1/T helper 2(Th1/Th2)balance drift with microvascular density(MVD)and postoperative recurrence in patients with cervical cancer.Methods A prospective study was conducted on 92 patients with cervical cancer(cervical cancer group)and 60 patients with outpatient treatment(benign group)in Mianyang Central Hospital,School of Medicine,University of Electronic Scinece and Technology of China from January to December 2017 were enrolled.Thl-type cytokines[interleukin-2(IL-2),interferon-γ(IFN-γ)] and Th2-type cytokines[interleukin-4(IL-4),interleukin-6(IL-6)]in serum were detected in both groups.Cervical cancer tissue,adjacent normal tissue and inflammatory cervix tissue were collected during surgery,CD34 tumor neovascularization was marked,to calculate the MVD count.The patients were followed up to April 2022,and the postoperative recurrence rate of cervical cancer was recorded,then the correlation of pathological features and postoperative recurrence of cervical cancer with serum Th1/Th2 and MVD was discussed.Results Compared with benign group,a decrease in IL-2 and IFNalong with an increase in IL-4 and IL-6 were observed in cervical cancer group,and the MVD expression was obviously up-regulated in cervical cancer tissues compared with adjacent normal tissues and inflammatory cervix tissue,with statistical difference(all P<0.05).Analysis showed,the expression levels of serum IL-4 and MVD in tumor tissue of cervical cancer patients of stage>Ib2 were higher than those with clinical stage≤Ib2,MVD expression of differentiation grade Ⅰ-Ⅱ was higher than that in grade Ⅱ,serum IL-6 and MVD expression levels in patients with primary tumor diameter>4 cm were higher than those in patients≤4 cm,and patients with deep myometrial invasion had lower IL-2 level and higher expression of IL-6 and MVD expression than those with superficial myometrial invasion,with statistical difference(P<0.05).Compared with non-recurrence group,recurrence group had decreased IL-2 and IFNlevels

关 键 词：宫颈癌 TH1/TH2漂移 微血管密度 术后复发 

分 类 号：R737.33[医药卫生—肿瘤]