深部热疗联合同步放化疗治疗中晚期宫颈癌的疗效及机制研究  

Effect of deep hyperthermia therapy combined with concurrent chemo-radiotherapy on advanced cervical cancer

作　　者：曹蕾[1] 陈鑫[2] 加静 郑明[2] 葛鹏[2] 

机构地区：[1]陕西省西安医学院第二附属医院妇科,西安710038 [2]陕西省西安医学院第二附属医院胸外肿瘤科,西安710038

出　　处：《广西医科大学学报》2017年第7期1051-1054,共4页Journal of Guangxi Medical University

摘　　要：目的:探讨深部热疗联合同步放化疗(CRT)治疗中晚期宫颈癌的疗效及对肿瘤组织细胞增殖、凋亡相关蛋白表达的影响。方法:将80例中晚期宫颈癌患者随机分为两组:对照组40例予以CRT,观察组40例予以深部热疗联合CRT。比较两组患者接受治疗后的近期疗效、生存情况及治疗前、后宫颈肿瘤活检组织中血管内皮生长因子(VEGF)、Bax、Bcl-2、p53蛋白表达情况。结果:观察组的肿瘤客观有效率显著高于对照组(95.00%vs 77.50%,P<0.05);治疗后,两组患者肿瘤组织中VEGF蛋白表达阳性率及Bcl-2/Bax比值均较治疗前降低,且治疗后观察组患者肿瘤组织中VEGF蛋白表达阳性率及Bcl-2/Bax比值显著低于对照组(P<0.05);与治疗前相比,两组患者治疗后肿瘤组织中Bax、p53蛋白表达阳性率均显著提高,且观察组患者治疗后肿瘤组织中Bax蛋白表达阳性率显著高于对照组,而p53蛋白表达阳性率显著低于对照组(P<0.05);观察组患者1年无瘤生存率显著高于对照组(83.78%vs 54.29%,P<0.05),但两组的总生存率比较,差异无统计学意义(91.89%vs85.71%,P>0.05)。结论:深部热疗联合CRT治疗中晚期宫颈癌疗效确切,能够提高近期疗效及无瘤生存率,其机制可能与抑制癌组织VEGF蛋白表达及p53基因突变,促进Bax表达、下调Bax/Bcl-2比值,从而影响细胞增殖及凋亡过程有关。Objective： To investigate the effect of deep hyperthermia combined with concurrent chemo-radiotherapy （CRT） on advanced cervical cancer and its influence on the expression of cell proliferation/apoptosis-related proteins. Methods： A total of 80 patients with advanced cervical cancer were randomly divided into a control group and an observation group, with 40 cases in each group. Patients in the control group received CRT treatment, while those in the observation group received CRT combined with deep hyperthermia therapy. The short-term effect, survival situation and the expression of vascular endothelial growth factor （VEGF）, Bax, Bcl-2 and p53 in tumor tissue before and after treatment were compared between the two groups. Results： The response rate in the observation group was significantly higher than that in the control group （P〈0.05）. After treatment, the expression of VEGF and Bax/Bcl-2 ratio in both groups were decreased, and the decrease in observation group was more significant （P〈0.05）. The positive expression rate of Bax and p53 in both groups were markedly increased （P〈0. 05）. The Bax positive rate in the observation group was higher than that in the control group, while p53 was significantly lower （P〈0.05）. The tumor-free survival rate within 1 year in the observation group was significantly higher than that in the control group （P〈0.05）. There was no significant difference in the overall survival rate between the two groups （P〉0.05）. Conclusion. The combined use of deep hyperthermia therapy and CRT was effective for the treatment of advanced cervical cancer. It could improve the short-term curative effect and elevate the tumor-free survival rate. The mechanism might be related to the inhibition of the expression of VEGF protein and p53 gene mutation in cancer tissue as well as up-regulating the Bax expression and reducing the Bax/Bcl-2 ratio.

关 键 词：宫颈癌 深部热疗 同步放化疗 VEGF 细胞凋亡 

分 类 号：R737.33[医药卫生—肿瘤]