两种新辅助化疗对宫颈癌微淋巴管密度和血管内皮生长因子表达的影响及疗效  

Effect of Two Different Neoadjuvant Chemotherapy on Lymphatic Microvessel Density,Expression of Vascular Endothelial Growth Factor and Clinical Outcomes in Uterine Cervical Cancer

作　　者：王晶[1] 陈滢[1] 汪晶[1] 童明[1] 杨赛花[1] 

机构地区：[1]广州军区武汉总医院妇产科,湖北武汉430070

出　　处：《武汉大学学报（医学版）》2015年第1期45-49,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨两种新辅助化疗(NACT)对宫颈癌微淋巴管密度和血管内皮生长因子表达的影响及疗效。方法:选择60例Ⅰb2-Ⅱb期宫颈鳞癌患者随机分为两组,分别行全身静脉化疗和髂内动脉栓塞灌注化疗,通过免疫组织化学法和实时定量PCR法,检测两种途径NACT前后的局部宫颈癌组织微淋巴管密度(LMVD)和血管内皮生长因子-A,C,D(VEGF-A,C,D)的表达量,并分析两种NACT疗效与临床病理因素的关系。结果:1VEGFA,C,D在癌症组织表达量明显高于正常组织。2经静脉化疗后,宫颈癌组织中VEGF-D治疗后的表达量低于治疗前(P<0.05),VEGF-A,C在治疗前后的表达量无明显变化;经动脉灌注化疗后,宫颈癌组织中VEGF-C,D治疗后的表达量明显低于治疗前(P<0.05),VEGF-A的表达量在治疗后也有所下降,但无统计学意义(P>0.05)。3静脉化疗和动脉灌注化疗均降低了宫颈癌组织内的LMVD,动脉灌注化疗降低程度更显著(P<0.05)。4两组患者均达到明显的近期临床缓解,动脉灌注化疗组患者的疗效优于静脉组,两组患者的总有效率有明显差异,且有统计学差异(P<0.05)。5静脉化疗疗效与肿瘤淋巴结转移及肿瘤直径有关,与临床分期、组织分化均无关;动脉灌注化疗总的有效率高达93%,但其疗效与临床分期、组织分化、淋巴结转移及肿瘤大小均无明显关系。结论:动脉灌注栓塞化疗在宫颈癌近期治疗效果好,可以有效抑制肿瘤淋巴管生成及血管内皮生长因子的表达。Objective：To investigate the outcomes of two ways of neoadjuvant chemotherapy（NACT）,and their effect on lymphatic microvessel density and expression of vascular endothelial growth factor in uterine cervical cancer.Methods：Sixty cases ofⅠb2-Ⅱb period cervical squamous cell carcinoma were randomly divided into two groups,respectively given Internal iliac arterial embolization in infusion chemotherapy and intravenous chemotherapy.By immunohistochemical method and real-time quantitative PCR method,lymphatic microvessel density and vascular endothelial growth factor（VEGF）-A,-C,and-D expression were assayed.The relationship between clinical response of the two NACTs and the clinic opathological characteristics was analyzed.Results：1VEGF-A,-C,and-D expression in cancer tissue were significantly higher than in normal tissue.2In intravenous chemotherapy group,VEGF-D expression in cervical cancer decreased after treatment（P〉0.05）,while expression of VEGF-A and-C showed no significant change.In transarterial infusion chemotherapy group,VEGF-C and-D expression in cervical cancer decreased after treatment（P〈0.05）,but the decrease of VEGF-A expression showed no significant difference（P〈0.05）.3 Both chemotherapy methods could reduce LMVD of cervical cancer,and transarterial infusion chemotherapy showed better effect（P〈0.05）.4 Patients in both groups had reached apparent clinical remission in short-term,arterial infusion chemotherapy patients showed better effect（P〈0.05）.5Tumor lymph node metastasis and tumor diameter wre related to the effect of intravenous chemotherapy,while clinical staging and tissue differentiation were not.The overall response rate of arterial infusion chemotherapy was 93%,and it is independent on clinical staging,tumor differentiation,lymph node metastasis,and tumor diameter.Conclusion：Internal iliac arterial embolization in infusion chemotherapy for cervical cancer shows good short-term effect and is helpful to inhibit the expression of VEGF and tumor lym

关 键 词：宫颈癌 新辅助化疗 髂内动脉栓塞灌注化疗 静脉化疗 血管内皮生长因子 微淋巴管密度 

分 类 号：R737.6[医药卫生—肿瘤]