【摘要】 目的探讨宫颈组织中血管内皮生长因子-C(VEGF-C)、血管内皮生长因子受体-3(VEGFR-3)的表达及人乳头瘤病毒16/18(HPV16/18)感染与宫颈鳞癌发生、浸润及转移的关系。方法选择2013年6月～2017年6月承德医学院附属医院86例宫颈鳞癌石蜡病理组织,选取宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ宫颈组织标本各12例,选取正常宫颈组织标本10例。对所有患者术前HPV16/18感染情况及宫颈组织中VEGF-C、VEGFR-3的表达水平进行观察和分析。结果浸润癌患者HPV16/18的感染率与CINⅠ、CINⅡ、CINⅢ患者比较,差异无统计学意义(P> 0.05),但两类患者HPV16/18的感染率均明显高于宫颈正常的患者(P <0.05)。浸润性癌组织中VEGF-C表达水平、VEGFR-3脉管阳性均数显著高于CINⅠ、CINⅡ、CINⅢ病理组织和正常宫颈上皮组织(P <0.05),而CINⅠ、CINⅡ、CINⅢ病理组织和正常宫颈上皮组织中VEGF-C的表达水平差异无统计学意义(P> 0.05),但CINⅢ病理组织中VEGFR-3脉管阳性均数显著高于正常宫颈上皮组织(P <0.05)。浸润癌Ⅲ期病理组织中VEGF-C表达水平、VEGFR-3脉管阳性均数显著高于Ⅰ期(P <0.05),浸润癌Ⅱ期病理组织中VEGFR-3脉管阳性均数显著高于浸润癌I期(P <0.05),淋巴结转移阳性组织中VEGF-C表达水平显著高于未转移组织(P <0.05)。VEGFR-3脉管阳性均数随着VEGF-C表达水平的升高而升高,VEGFR-3脉管阳性均数与VEGF-C表达水平呈正相关(P <0.05)。结论长时间持续性HPV16/18感染可能是导致宫颈鳞癌发生的重要因素,VEGF-C、VEGFR-3的表达与宫颈鳞癌的浸润及转移密切相关,其表达与宫颈鳞癌的分期及淋巴结是否转移相关,VEGF-C的表达促进VEGFR-3的激活从而进一步加重病灶浸润。更多还原

【Abstract】 Objective To investigate the relationship between the expression of vascular endothelial growth factor-C(VEGF-C),vascular endothelial growth factor receptor-3(VEGFR-3),human papillomavirus 16/18(HPV16/18) infections and the occurrence,invasion and metastasis of cervical squamous cell carcinoma. Methods 86 cases of paraffin pathologic tissue of cervical squamous cell carcinoma from June of 2013 to June of 2017 were selected. 12 cases of CIN Ⅰ and CIN Ⅱ cervical tissue specimens were selected,and 10 cases of normal cervical tissue specimens were selected. The preoperative infections of HPV16/18 and the expression of VEGF-C and VEGFR-3 in cervical tissues were observed and analyzed. Results There was no significant differences of the infection rates of HPV16/18 among invasive cancer patients and CIN Ⅰ,CIN Ⅱ,CIN Ⅲ patients(P > 0.05),but the infection rate of HPV16/18 in both groups was significantly higher than that of the patients with normal cervical tissues(P < 0.05). The expression level of VEGF-C and the mean of VEGFR-3 positive vessels in invasive carcinoma tissues were significantly higher than those in CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and normal cervical tissues(P < 0.05),while the expression level of VEGF-C in CIN Ⅰ,CIN Ⅱ,CIN Ⅲand normal cervical epithelium tissues had no statistical differences(P > 0.05),the mean of VEGFR-3 positive vessels in CIN III pathological tissues was significantly higher than that in normal cervical tissues(P < 0.05). The expression level of VEGF-C and the mean of VEGFR-3 positive vessels in stage Ⅲ infiltrating cancer tissues were significantly higher than those in stage I infiltrating cancer tissues(P < 0.05). The mean of VEGFR-3 positive vessels in stage Ⅱ infiltrating cancer tissues was significantly higher than that in stage I infiltrating cancer tissues(P < 0.05). The expression level of VEGF-C in lymph node metastasis positive tissues was significantly higher than that in lymph node metastasis negative tissues. The mean of VEGFR-3 positive vessels increased with the increase of the expression level of VEGF-C. The mean of VEGFR-3 positive vessels was positively correlated with the expression level of VEGF-C(P < 0.05). Conclusion The long time of persistent HPV16/18 infection may be the leading cause of cervical squamous cell carcinoma. VEGF-C and VEGFR-3 are closely related to the invasion and metastasis of cervical squamous cell carcinoma,and their expression is related to the stage and lymph node metastasis of cervical squamous cell carcinoma. The expression of VEGF-C promotes the activation of VEGFR-3,further aggravating the infiltration of lesions.更多还原