紫杉醇与顺铂联合化疗治疗宫颈癌的疗效及与组织微血管和微淋巴管密度的关系  

Efficacy of paclitaxel and cisplatin chemotherapy in treatment of cervical cancer and their relationship with lymphatic vessel density and microvascular density

作　　者：卢建军[1] 张林燕[1] 

机构地区：[1]内蒙古医科大学附属医院妇产科,内蒙古呼和浩特010050

出　　处：《中国生化药物杂志》2014年第5期92-94,共3页Chinese Journal of Biochemical Pharmaceutics

基　　金：内蒙古自治区自然科学基金项目(2013MS1143)

摘　　要：目的 探讨紫杉醇与顺铂联合化疗治疗宫颈癌的疗效及与组织微血管和微淋巴管密度的关系.方法 随机选取内蒙古医科大学附属医院2012年5月～ 2013年12月诊治的55例宫颈癌患者,所有患者术前行紫杉醇135 mg/m2和顺铂25 mg/m2联合化疗3个疗程,观察临床疗效;术后收集石蜡组织,行淋巴管内皮细胞透明质酸受体1 (lymphatic endothelium specific hyaluronan receptor-1,LYVE-1)、CD31免疫组织化学染色,高倍镜下观察计数各病例的微淋巴管密度(lymphatic vessel density,LVD)和微血管密度(microvascular density,MVD),分析该化疗方案与组织微血管和微淋巴管密度的关系.结果 共有44例患者完全缓解,部分缓解8例,总有效率为94.54％;高微淋巴管密度组(＞6.0个)和高微血管密度组(≥20.0个)患者完全缓解率分别为90.65％和84.21％,明显高于低微淋巴管密度组和低微血管密度,差异有统计学意义(P＜0.05).进一步分析MVD和LVD与临床病理参数的关系,绝经病例的病灶内及病灶周围正常组织的微淋巴管密度(病灶内1.01 ±0.21;病灶周围正常组织4.84 ±0.43)明显高于未绝经病例(病灶内0;病灶周围正常组织3.85 ±0.50),差异有统计学意义(P＜0.01);FIGO分期越高的病例,其病灶周围正常组织的微淋巴管密度越高(宫颈癌Ib 4.67±0.56;Ib 5.68 ±0.60;lib 6.68±0.62;).绝经病例的病灶内及病灶周围正常组织的微血管密度(病灶内18.66±1.21;病灶周围正常组织16.48±1.66)明显高于未绝经病例(病灶内14.33±1.45;病灶周围正常组织13.15±1.50),差异有统计学意义(P＜0.01);FIGO分期越高的病例,其病灶周围正常组织的微血管密度越高(宫颈癌Ib 16.67±1.06;Ⅱa 20.68±2.30;ib 22.68±2.62).结论 紫杉醇与顺铂联合化疗方案治疗宫颈癌的疗效肯定,且与宫颈癌组织LVD和MVD关系密切,LVD和MVD可作为宫颈CIN和早期宫颈癌发展的预测指标之一.Objective To evaluate the efficacy of paclitaxel and cisplatin chemotherapy in treatment with cervical cancer and its relationship with lymphatic vessel density(LVD) and microvascular density(MVD). Methods 55 cases with cervical cancer from May 2012 to December 2013 collected in Affiliated Hospital of Inner Mongolia Medical University were given paclitaxel and cisplatin chemotherapy for three periods before surgery. Paraffin serial sections after surgery were collected,lymphatic endothelial hyaluronan receptor 1( LYVE 1) and CD31 were observed by immunohistochemical staining,and lymphatic vessel density( LVD) and microvascular density( MVD) were counted at high magnification. The relationship between the chemotherapy treatmen and the number of LVD and MVD were analyzed. Results A total of 44 cases with complete remission,partial in 8 cases,the total effective rate was 94. 54%. High micro lymphatic vessel density group( ≥6. 0) and high microvascular density group( ≥20. 0) in patients with complete remission rate were 90. 65% and 84. 21%,respectively,significantly higher than the group of low lymphatic vessel density and low microvascular density(P < 0. 05). The relationship between MVD and LVD and clinicopathological parameters were analyzed,LVD and MVD of lesions and around the lesions in postmenopausal cases were both obviously higher than those of menstruating cases( P < 0. 01);The higher FIGO staging of cases,the more LVD and MVD in normal tissue around the lesions( P < 0. 01). Conclusion Paclitaxel and cisplatin chemotherapy has well curative effect on cervical cancer,and closely associated with cervical LVD and MVD. LVD and MVD could be used as one of the predictors of early cervical CIN and cervical cancer development.

关 键 词：紫杉醇 顺铂 宫颈癌 微血管 微淋巴管 化疗 

分 类 号：R737.33[医药卫生—肿瘤]