新辅助介入化疗可显著促进局部晚期宫颈癌治疗

本研究选择自2011年1月至2016年1月间在我院妇产科收治并确诊的90例肿瘤直径大于4 cm的Ⅰb～Ⅱb期宫颈癌患者作为研究对象,随机分为A组、B组和对照组,每组30例,A组患者手术前采用动脉介入新辅助化疗,B组患者手术前采用静脉介入新辅助化疗,对照组患者仅采用手术治疗,并对3组疗效及副作用进行了分析,采用免疫组化法检测治疗前后3组患者MMP-2、Fas和FasL细胞因子的表达情况,以探讨新辅助介入化疗在局部晚期宫颈癌治疗中的疗效。研究结果表明:A组(有效率=83.33%)和B组(有效率=73.33%)疗效显著高于对照组(p<0.05),并且A组疗效显著高于B组(χ~2=2.116, p=0.045);Ⅰb期有效率显著高于Ⅱa和Ⅱb,Ⅱa显著高于Ⅱb,鳞癌患者的化疗有效率显著高于腺癌,低分化宫颈癌患者有效率显著低于中分化和高分化(p<0.05);A组中共有14例出现化疗副作用,B组共有11例出现副作用,两组差异无统计学意义(p>0.05);MMP-2和FasL治疗后的阳性率在A组和B组中均较治疗前显著下降,而A组和B组中Fas阳性率治疗后较治疗前显著升高(p<0.05),而对照组中MMP-2、Fas和FasL治疗前后的阳性率差异均无统计学意义(p>0.05)。本研究的结论初步说明:新辅助介入化疗在局部晚期宫颈癌治疗中的效果显著,MMP-2、Fas和FasL细胞因子与宫颈癌肿瘤细胞密切相关。

Neoadjuvant Interventional Chemotherapy Could Significantly Facilitate the Treatment of Locally Advanced Cervical Carcinoma

In this research,90 cervical cancer patients treated and identified in our hospital from January 2011 to January 2016 were selected as subjects,in stages from Ib to IIb with tumor diameter greater than 4 cm,which were randomly divided into group A,group B and control group,and each group included 30 cases.Group A patients were treated with arterial interventional neoadjuvant chemotherapy before surgery;Group B patients were treated with venous interventional neoadjuvant chemotherapy before surgery,and the patients in the control group were only treated with surgery.The efficacy and side effects of the three groups were analyzed.The expression situation of MMP-2,Fas and FasL cytokines in three groups before and after treatment were detected by immunohistochemistry to explore the clinic effect of neoadjuvant interventional chemotherapy in the treatment of locally advanced cervical cancer.The results showed that the effective rate of group A(83.33%)and group B(73.33%)was significantly higher than that of the control group(p<0.05),andthe effect of group A was significantly higher than thatof groupB(χ^2=2.116,p=0.045).The effective rate in Ib stage was significantly higher than that of IIa and IIb,while IIa was significantly higher than that of IIb,and the effective rate of chemotherapy in patients with squamous carcinoma wa s significantly higher than that of adenocarcinoma,and the efficiency of poorly differentiated cervicalcancer patients was significantly lower than that ofmiddle differentiation and high differentiation(p<0.05).In group A,there were 14 cases of chemotherapy side effects,group B had a total of 11 cases of that,and there was no significant difference between the two groups(p>0.05).The positive rate of MMP-2 and FasL in group A and group B after treatment were lower than those before treatment,while the positive rate of Fas in group A and group B after treatment was significantlyhigher than those before treatment(p<0.05),and there were no significant difference of the positive rate of MMP-2,Fas and FasL in control group before and after treatment(p>0.05).The study preliminarily concluded that neoadjuvant interventional chemotherapy would be effective in the treatment of locally advanced cervical cancer,and cytokines of MMP-2,Fas and FasL might be closely related to cervical cancer tumor cells.