摘要
目的了解子宫内膜癌(endometrial cancer,EC)患者血清中丝氨酸蛋白酶抑制剂B5(serine protease inhibitors B5,Serpin B5)、Ras相关C3肉毒毒素底物1(Ras-related C3 botulinum toxin substrate 1,Rac1)、P21活化激酶1(P21 activates kinase 1,PAK1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)及可溶性血管内皮生长因子受体-1(soluble vascular endothelial growth factor receptor-1,sVEGFR1)水平表达及其与不同临床特征的相关性。方法选取2022年3月至2024年5月深圳市龙华区人民医院EC确诊患者66例为EC组,同时选取健康育龄妇女82例为对照组。采用酶联免疫吸附(enzyme-linked immunosorption,ELSIA)法检测Serpin B5,Rac1,PAK1,VEGF及sVEGFR1水平,并收集2组临床资料,分析不同组水平的差异性及与不同临床特征的相关性。同时采用受试者工作特征曲线(ROC曲线)评估上述指标对EC患者的诊断效能。结果EC组Serpin B5(ng/mL)和sVEGFR1水平(ng/mL)(40.15±8.18和289.89±77.24)明显低于对照组(65.84±20.90和459.52±127.63),而Rac1(ng/mL),PAK1(ng/mL)及VEGF水平(ng/L)(23.20±5.93,29.14±9.29ng/mL及272.16±68.18)明显高于对照组(13.82±5.93,16.79±6.92及196.28±56.80),差异有统计学意义(t=23.379,49.115,22.785,16.538,11.446,均P<0.01);Ⅲ~Ⅳ期、分化程度越低、有淋巴结转移及浸润程度≥1/2肌层患者Serpin B5和sVEGFR1水平降低更为明显,而Rac1,PAK1及VEGF水平升高更为明显,差异有统计学意义(均P<0.05);经Spearman相关分析,Serpin B5和sVEGFR1水平与FIGO分期、淋巴结转移及肿瘤浸润程度呈负相关,与分化程度呈正相关,而Rac1,PAK1及VEGF水平与FIGO分期、淋巴结转移及肿瘤浸润程度呈正相关,而与分化程度呈负相关(均P<0.05);经Pearson相关性分析,Serpin B5与sVEGFR1水平呈正相关,而与Rac1,PAK1,VEGF水平呈负相关(r=0.7960,-0.7668,-0.7292,-0.8312,均P<0.05);通过ROC曲线分析,Serpin B5,Rac1,PAK1,VEGF及sVEGFR1水平对EC诊断均具有较高的诊断效能。结论EC患者Serpin B5和sVEGFR1水平明显降低,而Rac1,PAK1及VEGF水平明显升高,且与不同病理特征存在一定相关性,对EC患者诊断具有较高的诊断效能,可作为EC早期诊断、治疗及病情评估潜在的血清标志物。
Objective To investigate the expression levels of Serine protease inhibitor B5(Serpin B5),Ras-related C3 botulinum toxin substrate 1(Rac1),P21-activated kinase 1(PAK1),Vascular endothelial growth factor(VEGF),and Soluble vascular endothelial growth factor receptor-1(sVEGFR1)in the serum of patients with endometrial cancer(EC)and their correlation with various clinical characteristics.Methods Sixty-six patients diagnosed with EC at Longhua District People′s Hospital between March 2022 and May 2024 were included in the EC group,while 82 healthy women of reproductive age were included as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of Serpin B5,Rac1,PAK1,VEGF,and sVEGFR1.Clinical data were collected for analysis of differences in expression levels between groups and their correlations with clinical characteristics.Receiver operating characteristic(ROC)curves were applied to assess the diagnostic efficacy of these markers for EC.Results The levels of Serpin B5(ng/mL)and sVEGFR1(ng/mL)in the EC group(40.15±8.18 and 289.89±77.24)were significantly lower than those in the control group(65.84±20.90 and 459.52±127.63),whereas Rac1(ng/mL),PAK1(ng/mL),and VEGF(ng/L)levels(23.20±5.93,29.14±9.29,and 272.16±68.18)were significantly higher than those in the control group(13.82±5.93,16.79±6.92,and 196.28±56.80)(t=23.379,49.115,22.785,16.538,11.446,all P<0.01).In patients with FIGO stageⅢ-Ⅳ,low differentiation,lymph node metastasis,and deep myometrial invasion(≥1/2),Serpin B5 and sVEGFR1 levels were significantly reduced,while Rac1,PAK1,and VEGF levels were significantly elevated(P<0.05).Spearman correlation analysis showed that Serpin B5 and sVEGFR1 levels were negatively correlated with FIGO stage,lymph node metastasis,and tumor invasion,but positively correlated with differentiation degree(P<0.05).Conversely,Rac1,PAK1,and VEGF levels were positively correlated with FIGO stage,lymph node metastasis,and tumor invasion,but negatively correlated with differentiation degree(P<0.05).Pearson correlation analysis revealed a positive correlation between Serpin B5 and sVEGFR1 levels,but a negative correlation with Rac1,PAK1,and VEGF levels(r=0.7960,-0.7668,-0.7292,-0.8312,all P<0.05).ROC curve analysis demonstrated that Serpin B5,Rac1,PAK1,VEGF,and sVEGFR1 levels all exhibited high diagnostic efficiency for EC.Conclusion In EC patients,Serpin B5 and sVEGFR1 levels are significantly reduced,while Rac1,PAK1,and VEGF levels are significantly increased.These markers are associated with specific pathological features and possess high diagnostic efficacy,indicating their potential use as serum biomarkers for the early diagnosis,treatment,and assessment of disease status in EC.
作者
廖定君
陈美连
乔艳
张燕
李甜甜
LIAO Ding-jun;CHEN Mei-lian;QIAO Yan;ZHANG Yan;LI Tian-tian(Department of Gynecology,Longhua District People′s Hospital,Shenzhen 518109,Guangdong,China)
出处
《广东医学》
2025年第7期1083-1088,共6页
Guangdong Medical Journal
基金
深圳市龙华区医疗卫生机构区级科研项目(2021019)。
