血清M-CSF、sTNFRⅠ在宫颈上皮内瘤变与宫颈癌鉴别诊断中的作用  

Role of serum M-CSF and sTNFRⅠin the differential diagnosis of cervical intraepithelial neoplasia and cervical cancer

作　　者：王萍[1] 耿江 WANG Ping;GENG Jiang(Department of Gynecology and Oncology,Shanxi Provincial Cancer Hospital,Cancer Hospital of Chinese Academy of Medical Sciences,Shanxi Hospital,Affiliated Cancer Hospital of Shanxi Medical University,Taiyuan 030013,Shanxi,China;Department of Personnel,Shanxi Provincial Cancer Hospital,Cancer Hospital of Chinese Academy of Medical Sciences,Shanxi Hospital,Affiliated Cancer Hospital of Shanxi Medical University,Taiyuan 030013,Shanxi,China)

机构地区：[1]山西省肿瘤医院·中国医学科学院肿瘤医院山西医院·山西医科大学附属肿瘤医院妇瘤科,山西太原030013 [2]山西省肿瘤医院·中国医学科学院肿瘤医院山西医院·山西医科大学附属肿瘤医院人事科,山西太原030013

出　　处：《川北医学院学报》2023年第8期1102-1105,共4页Journal of North Sichuan Medical College

摘　　要：目的:探究血清巨噬细胞集落刺激因子(M-CSF)、可溶性肿瘤坏死因子受体Ⅰ(sTNFRⅠ)在宫颈上皮内瘤变(CIN)与宫颈癌鉴别诊断中的作用。方法:选取217例宫颈癌患者(宫颈癌组)及231例CIN患者[CINⅠ级109例(CINⅠ组)、CINⅡ级72例(CINⅡ组)、CINⅢ级50例(CINⅢ组)]为研究对象。比较各组患者血清巨噬细胞集落剌激因子(M-CSF)、可溶性肿瘤坏死因子受体Ⅰ(sTNFRⅠ)水平,分析各指标与CIN分级及宫颈癌病理特征的关系,判断各指标对CIN及宫颈癌的诊断价值。结果:各组患者血清M-CSF、sTNFRⅠ水平比较:CINⅠ组<CINⅡ组<CINⅢ组<宫颈癌组,差异均有统计学意义(P<0.05)。CIN患者血清M-CSF、sTNFRⅠ水平与CIN分级呈正相关(P<0.05)。宫颈癌患者血清M-CSF、sTNFRⅠ水平随FIGO分期的升高而升高;肿瘤低、中分化患者血清M-CSF、sTNFRⅠ水平高于肿瘤高分化患者;存在淋巴结转移患者血清M-CSF、sTNFRⅠ水平高于未出现淋巴结转移患者(P<0.05)。血清M-CSF、sTNFRⅠ水平联合检测鉴别CIN及宫颈癌的曲线下面积(AUC)大于各指标单独检测(P<0.05)。血清M-CSF、sTNFRⅠ水平升高是影响CIN进展为宫颈癌的危险因素(P<0.05)。结论:宫颈癌患者血清M-CSF、sTNFRⅠ高于CIN患者,血清指标联合检测对宫颈癌及CIN具有鉴别价值,且各指标变化与宫颈癌病理特征有关。Objective:To explore the role of serum macrophage colony-stimulating factor(M-CSF)and soluble tumor necrosis factor receptorⅠ(sTNFRⅠ)in the differential diagnosis of cervical intraepithelial neoplasia(CIN)and cervical cancer.Methods:217 patients with cervical cancer(cervical cancer group)and 231 patients with CIN[109 cases of CINⅠ(CINⅠgroup),72 cases of CINⅡ(CINⅡgroup),50 cases of CINⅢ(CINⅢgroup)]were selected as the study subjects.The levels of serum M-CSF and sTNFRⅠwere compared between the groups,and the relationship of various indicators with CIN grading and pathological characteristics of cervical cancer as well as the value of distinguishing CIN and cervical cancer were analyzed.Results:Comparison of serum M-CSF and sTNFRⅠlevels among groups:CINⅠgroup<CINⅡgroup<CINⅢgroup<cervical cancer group,with statistically significant differences(P<0.05).Serum M-CSF and sTNFRⅠlevels in patients with CIN were positively correlated with CIN grading(P<0.05).The levels of serum M-CSF and sTNFRⅠin patients with cervical cancer were increased with the increase of FIGO stage,and the levels of serum M-CSF and sTNFRⅠin patients with low-to-moderate tumor differentiation were higher than those in patients with high tumor differentiation,and the two levels in patients with lymph node metastasis were higher than those in patients without lymph node metastasis(P<0.05).The AUC value of the combined detection of serum M-CSF and sTNFRⅠin distinguishing CIN and cervical cancer was higher than that of the single detection(P<0.05).Increased serum M-CSF and sTNFRⅠlevels were risk factors for the progression of CIN into cervical cancer(P<0.05).Conclusion:Serum M-CSF and sTNFRⅠin patients with cervical cancer are higher than those in patients with CIN.The combined detection of serum indicators has differential value on cervical cancer and CIN,and the changes of various indicators are related to the pathological characteristics of cervical cancer.

关 键 词：宫颈癌 宫颈上皮内瘤变 巨噬细胞集落刺激因子 可溶性肿瘤坏死因子受体Ⅰ 血清水平 相关性 

分 类 号：R737.33[医药卫生—肿瘤]