宫颈癌新辅助化疗疗效评估  

Evaluation of treatment response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer

作　　者：阮晓红[1] 钟开运[1] 杨爱莲[1] 罗中明[1] 练晓勤[1] 

机构地区：[1]中山大学附属江门医院妇产科,广东江门529070

出　　处：《中国实用妇科与产科杂志》2009年第9期688-690,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨在局部晚期宫颈癌患者新辅助化疗(NACT)疗效观察及预测方面的价值。方法2000年3月至2008年3月在中山大学附属江门医院妇科对86例符合入选条件的Ⅰb2～Ⅱb期原发性宫颈癌患者进行新辅助化疗,根据NACT临床疗效分为NACT有效组和无效组,分析两组NACT前后肿瘤组织的细胞凋亡指数(AI)、微血管密度(MVD)、血清鳞状细胞癌抗原(SCC抗原)水平的变化及三者与NACT疗效的关系。结果NACT后有效组AI明显增加,血清SCC水平明显降低,与NACT前相比差异均有统计学意义(P=0.011,P=0.039),而MVD较NACT前降低,但差异无统计学意义(P=0.071)。有效组NACT前的AI明显高于无效组(P=0.027),MVD、SCC水平高于无效组,但差异均无统计学意义(P=0.87,P=0.357)。有效组初次NACT后血清SCC降幅明显大于无效组(P<0.001)。AI≥1.0者化疗有效率大于AI<1.0者(P=0.042),初次NACT后SCC降幅≥50%者NACT有效率大于初次NACT后SCC降幅<50%者(P=0.021)。结论AI及SCC可在一定程度上反映NACT疗效,NACT前AI及宫颈鳞状细胞癌初次NACT后SCC降幅可作为预测NACT疗效的指标。Objective To investigate the clinical effect and predictive value of AI, MVD of tumor tissue and SCC level in the serum in patients with bulky and locally advanced cervical cancer treated by NACT. Methods Between March 2000 and March 2008, 86 women with primary cervical cancer of FIGO stage Ⅰb2-Ⅱb in the Affiliated Jiangmen Hospital of Sun Yat-Sen University were treated by NACT. They were divided into the effective group and non-effective group according to the clinical response to NACT. AI and MVD of the carcinoma and serum SCC level in patients with squamous cell carcinoma of the two groups before and after NACT were evaluated and the relationship between the changes of the three parameters and the clinical results were analyzed. Results In effective group, the mean AI value after NACT was significantly increased than that before NACT （P=0.011）, while serum SCC level decreased significantly （P=0.039）. A little decrease was found in MVD but without statistic significance （P=0.071）. Before NACT, the mean AI was significantly higher in effective group than non-effective one （P=0.027） but no statistic significance was found in MVD and the serum SCC level between two groups （P=0.87 ,P = 0.357）. In the squamous cell carcinoma, the reduction percentage in serum SCC level after first NACT in effective group was significantly increased than non-effective one （P 〈0.001）. AI higher than 1.0 before NACT and the reduction percentage in serum SCC level of the squamous cell carcinoma after first NACT higher than 50% index were associated with a better clinical effect （P=0.042,P =0.021）. Conclusion AI and serum SCC level are useful parameters in evaluating NACT response. The AI level before NACT and the reduction percentage of serum SCC level after first NACT in the squamous cell carcinoma are valuable of predicting the re- sponse to NACT.

关 键 词：宫颈肿瘤 新辅助化疗 细胞凋亡 微血管密度 鳞状细胞癌抗原 

分 类 号：R71[医药卫生—妇产科学]