PCNA和SCCA对宫颈鳞癌NACT敏感性和疗效的预测价值

目的:探讨增殖细胞核抗原(PCNA)及鳞状细胞癌抗原(SCCA)作为评价宫颈鳞癌新辅助化疗(NACT)敏感性及疗效指标的可行性。方法:收集2006年4月～2012年4月桂林医学院附属医院56例IB2～IIB期宫颈鳞癌NACT前后组织标本及其中的2011年4月～2012年4月16例宫颈鳞癌NACT前后血清标本,采用免疫组化法测定癌组织中PCNA的表达,ELISA检测血清中SCCA的表达。结果:56例宫颈鳞癌经NACT治疗2～3周后评价临床疗效,临床总有效率为67.9%(38/56)。有效组NACT前组织PCNA指数及血清SCCA水平均高于无效组(P<0.01),有效组PCNA指数及血清SCCA水平化疗后明显下降(P<0.01)。NACT后组织PCNA降幅和血清SCCA降幅与肿瘤缩小比例之间有显著相关性(r=0.808,P<0.01;r=0.708,P<0.05)。结论:联合检测组织增殖细胞核抗原及血清鳞状细胞癌抗原可作为评价宫颈鳞癌新辅助化疗敏感性和疗效的有效指标之一。

Values of PCNA and SCCA for predicting the sensitivity and curative effect of NACT for cervical squamous cell carcinoma

Objective:To explore the feasibilities of proliferating cell nuclear antigen(PCNA) and squamous cell carcinoma antigen(SCCA) as markers for predicting the sensitivity and curative effect of neoadjuvant chemotherapy(NACT) for cervical squamous cell carcinoma.Methods:The 56 samples of cervical squamous cell carcinoma of ⅠB2-ⅡB before and after NACT from the hospital from April 2006 to April 2012 were collected,and the serum samples of 16 patients with cervical squamous cell carcinoma before and after NACT from the hospital from April 2011 to April 2012 were also collected;immunohistochemical method was used to detect the expression of PCNA in cervical squamous cell carcinoma,ELISA was used to detect the expression of SCCA in serum.Results:Fifty-six patients with cervical squamous cell carcinoma were treated with NACT for 2-3 weeks,the total clinical effective rate was 67.9%(38/56).PCNA index and serum SCCA level before NCAT in efficacy group were statistically significantly higher than those in non-efficacy group(P<0.01),after NACT,PCNA index and serum SCCA level in efficacy group decreased significantly(P<0.01).After NACT,there were significant correlations between the decreasing amplitudes of PCNA index and serum SCCA level and the decreasing proportion of tumor size,respectively(γ=0.808,P<0.01;γ=0.708,P<0.05).Conclusion:Joint detection of PCNA and serum SCCA can be used as effective markers to evaluate the sensitivity and curative effect of NACT for cervical squamous cell carcinoma.