介入栓塞化疗对局部晚期宫颈癌组织VEGF表达及MVD影响

目的 探讨介入栓塞化疗对宫颈癌血管内皮生长因子（VEGF）及微血管密度（MVD）的影响及其临床意义。方法 应用RT-PCR方法 测定47例局部晚期宫颈癌病人介入栓塞化疗前后癌组织中VEGF表达,并进行MVD计数,评定化疗近期效果。结果 介入栓塞化疗的总有效率80.9%,ⅠB2期、ⅡA期、ⅡB期宫颈癌介入化疗效果无明显差异（P〉0.05）;ⅢA期及ⅢB期宫颈癌介入治疗效果无明显差异（P〉0.05）,且治疗有效率明显低于前3组（χ^2=3.98～6.11,P〈0.05）。治疗前局部晚期宫颈癌组织中VEGF的表达与肿瘤的临床分期、淋巴结转移、病理类型、组织学分级均明显相关（t=2.4、3.0,F=5.62、7.12,P〈0.05）;介入治疗后高分化宫颈癌及无淋巴结转移的宫颈癌中VEGF表达无明显下降（P〉0.05）;不同临床分期、有淋巴结转移、不同病理类型及中、低分化的局部晚期宫颈癌介入治疗后VEGF表达均较治疗前明显降低（t=1.84～13.20,P〈0.05）;介入栓塞化疗后MVD计数明显降低（t=21.92～53.51,P〈0.01）。结论 术前介入栓塞化疗能降低宫颈癌组织VEGF的表达,减少MVD计数,能减小肿瘤体积,提高手术切除率,是一种可行、有效的辅助治疗手段。

INFLUENCE OF INTERVENTIONAL CHEMOTHERAPY ON THE EXPRESSIONS OF VEGF AND MVD IN LOCALLY ADVANCED CERVICAL CANCER

Objective To investigate the effect of interventional chemotherapy through artery on the expressions of VEGF and MVD in locally advanced cervical cancer （LACC）. Methods The expression of VEGF mRNA was detected by RT- PCR and MVD evaluated in the tissues of 47 LACC patients. The effectiveness was assessed. Results The total effective rate was 80.9%. There was no significant difference in effective rate between Ⅰ B2/Ⅱ A and Ⅱ B（P〉0.05）, nor was between Ⅲ A and ⅢB（P〉0.05）. But the effective rate in ⅢA and ⅢB group was lower than in ⅠB2/ⅡA and ⅡB group （Х^2=3.98-6. 11,P〈 0.05）. The levels of VEGF mRNA expression was significantly associated with the clinical stage, lymph node metastasis, pathological type and histological gade （t： 2.4,3.0;F= 5.62,7.12;P〈20.05）. After chemotherapy, there was no significant change of VEGF-mRNA expression in highly-differentiated cancer and cancer without lymph node metastasis. But the expressions of VEGF and MVD in LACC with different clinical stages, lymph node metastasis, and different types of pathology, the moderately and poorly differentiated cancer were significantly reduced after the treatment （t=21.92-53.51 ,P〈0.01）. Conclusion Preoperative interventional chemotherapy can effectively reduce the expressions of VEGF and MVD. It can reduce tumor size and increase the rate of complete surgical removal of the tumor, which is a feasible and effective treatment for locally advanced cervical cancer.