NACT对晚期卵巢癌的疗效及癌组织免疫组化表达的影响  

Therapeutic effect of neoadjuvant chemotherapy on advanced ovarian cancer of women and its influence on expression of immunohistochemical cytokines in cancerous tissues

作　　者：张焱[1] 王景美[2] 徐晓峰[1] 周怀君[1] ZHANG Yan;WANG Jingmei;XU Xiaofeng;ZHOU Huaijun(Department of Gynecology,The Affiliated Drum Tower Hospital,Medical College of Nanjing University,Jiangsu Nanjing 210008,China;Department of Pathology,The Affiliated Drum Tower Hospital,Medical College of Nanjing University,Jiangsu Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院妇科,江苏南京210008 [2]南京大学医学院附属鼓楼医院病理科,江苏南京210008

出　　处：《中国妇幼健康研究》2022年第1期73-79,共7页Chinese Journal of Woman and Child Health Research

基　　金：南京市卫计委基金资助项目(YKK16090)。

摘　　要：目的探讨新辅助化疗(NACT)对晚期卵巢癌患者的疗效及对癌组织免疫组化表达的影响。方法回顾性分析2003年2月至2018年6月就诊于南京大学医学院附属鼓楼医院的164例晚期上皮性卵巢癌患者的临床资料,根据不同治疗方法将其分为NACT-中间性肿瘤细胞减灭术(IDS)组(41例)和初始肿瘤细胞减灭术(PDS)组(123例)。采用免疫组化法检测患者癌组织中p53、p16、细胞周期蛋白D1(CyclinD1)、雌激素受体(ER)、孕激素受体(PR)及Ki67水平的表达,并对其进行统计分析。结果 NACT-IDS组与PDS组患者术前CA125分布比较差异有统计学意义(采用等级资料显著性检验,P=0.006);而年龄、初潮年龄,以及绝经、恶性肿瘤家族史、术前CA199、腹水脱落细胞学检查、FIGO分期、组织学分级的分布比较差异均无统计学意义(P>0.05)。两组患者免疫组化检测结果显示,p53、p16、CyclinD1、ER、PR的阳性率,以及Ki67水平比较差异均无统计学意义(P>0.05)。采用log rank分析,NACT-IDS组与PDS组的总生存期(OS)比较差异有统计学意义(P=0.004);NACT-IDS组与PDS组的无进展生存期(PFS)比较差异无统计学意义(P=0.243)。腹水脱落细胞学检查阳性和是否绝经均为影响患者生存时间的独立预后因素(采用等级资料显著性检验,P值分别为0.017、0.004)。结论 NACT对无进展生存时间无明显影响,NACT对癌组织中p53、p16、CyclinD1、ER、PR、Ki67的表达无明显影响。Objective To investigate therapeutic effect of neoadjuvant chemotherapy(NACT) on advanced ovarian cancer of women and its influence on expression of immunohistochemical cytokins in cancerous tissues.Methods The clinical data of 164 patients with advanced ovarian cancer who were diagnozed and treated in The Affiliated Drum Tower Hospital, Medical College of Nanjing University over a period from February 2003 to June 2016 were retrospectively analyzed.These patients with advanced ovarian cancer who received combined treatment of NACT with interval debulking surgery(IDS) were divided into NACT-IDS group(n=41) and those patients with advanced ovarian cancer who received single primary debulking surgery(PDS) were divided into PDS group(n=123).Immunohistochemistry was used to detect expression levels of P53,P16,cell cycle protein D1(CyclinD1),estrogen receptor(ER),progesterone receptor(PR) and Ki67 in the cancerous tissues.The data were analyzed statistically.Results Before treatment, there was a significant difference in preoperative CA-125 between the two groups(by rank data significance test, P=0.006),while there were no significant differences in other clinical and immunohistochemical indexes such as age of the woman, age of menarche, menopausal status and family history of malignant tumours, preoperative serum CA199 level, result of exfoliative cytologic examination of ascites, clinical stage by FIGO and histological grading between NACT-IDS group and PDS group(all P>0.05).The immunohistochemical results shown that there were no significant differences in positive rates of p53,p16,CyclinD1,ER and PR,and Ki67 level(all P>0.05).Log rank analysis shown that the overall survival(OS) of the patients in NACT-IDS group was shorter than in PDS group, and the difference was significant(P<0.05),while in the progression-free survival(PFS) there was no significant difference between the two groups(P=0.243).Positive result of exfoliative cytological examination of ascites and menopausal status were both independent prognostic

关 键 词：新辅助化疗 卵巢癌 治疗结果 免疫组化 

分 类 号：R737.31[医药卫生—肿瘤]