熏洗1号配合放疗治疗Ⅰa～Ⅱb期子宫颈癌合并HR-HPV感染的临床研究  

Effect of Xunxi No.1 Intervention and Radiotherapy on Ⅰa-Ⅱb Stage Cervical Cancer with High-risk Human Papilloma Virus Infection

作　　者：张培影[1] 刘凌[1] 王旭波 吴勉华[3] 

机构地区：[1]江苏省徐州市中心医院肿瘤科,江苏221009 [2]江苏省徐州市中医院病理科,江苏221003 [3]南京中医药大学第一临床医学院中医内科,南京210029

出　　处：《中国中西医结合杂志》2011年第8期1066-1069,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：江苏省中医药局科研课题(No.HZ07099)

摘　　要：目的探讨中药干预和治疗高危型人乳头瘤病毒(HR-HPV)感染在子宫颈癌放射治疗中的临床价值。方法对首次放疗的80例Ⅰa～Ⅱb子宫颈癌患者随机分为两组,试验组常规放疗加用中药熏洗1号局部治疗干预20天,对照组单纯常规放疗。运用原位杂交技术检测两组患者治疗前后HR-HPV16/18型的表达水平,并观察两组患者肿瘤无瘤生存率(生存5年以上的比例)和盆腔淋巴结转移率(经CT证实淋巴结直径>0.9cm的病例)变化。结果疗程结束后,试验组HR-HPV阳性率由67.5%(27/40)降低到37.5%(15/40),差异有统计学意义(P<0.05);对照组由72.5%(29/40)降低到65.0%(26/40),差异无统计学意义。3年无瘤生存率显示试验组优于对照组(33/40vs27/40),但差异无统计学意义。5年无瘤生存率试验组65.0%(26/40),对照组42.5%(17/40);盆腔淋巴结转移率试验组为7.5%(3/40),对照组为25.0%(10/40);两组比较差异均有统计学意义(P<0.05)。结论在早期子宫颈癌放疗中配合使用中药熏洗1号,HR-HPV阳性率明显降低,肿瘤5年无瘤生存率优于单纯放疗组,且盆腔淋巴结转移率较低,具有较好的临床疗效。Objective To explore the clinical value of Chinese medical intervention and treatment of high-risk human papilloma virus （HR-HPV） infection in patients of cervical cancer （CC） during radiotherapy （RT）.Methods Eighty CC patients of the Ⅰa-Ⅱb stage receiving primary RT were assigned to two groups.RT and local intervention by Xunxi No.1 was given to patients in the test group for 20 days,while patients in the control group were treated with RT alone.Expression of high-risk HPV （HR-HPV,HPV16/18 infection） was detected by in-situ hybridization （ISH） before and after treatment.The 5-year disease free survival rate and pelvic lymph node metastasis rate （with the lymph node diameter0.9 cm shown by CT） in patients were observed.ResultsAfter treatment,the HR-HPV positive rate was lowered from 67.5% （27/40） to 37.5% （15/40） in the test group （P0.05）,while it was lowered from 72.5% （29/40） to 65.0% （26/40） in the control group （P0.05）.By follow-ups,the 3-year disease free survival rate in the test group was better than that in the control group （33/40 vs 27/40）,showing insignificant difference between the two groups （P0.05）.Significant difference was shown in the 5-year disease free survival rate and the pelvic lymph node metastasis rate （65.0% vs 42.5%,7.5% vs 25.0%） between the two groups （both P0.05）.Conclusions In early RT of CC,combined application of Xunxi No.1 could obviously lower the HPV positive rate.The 5-year disease free survival rate was superior to that in the control group,with lower pelvic lymph node metastasis rate.Xunxi No.1 had better clinical value in clinical application.

关 键 词：子宫颈癌 人乳头瘤病毒 放射治疗 中药干预 

分 类 号：R737.33[医药卫生—肿瘤]