动脉灌注栓塞化疗治疗宫颈癌的临床观察及对细胞增殖与凋亡的影响

目的 探讨动脉灌注栓塞化疗治疗宫颈癌的作用机制及临床疗效.方法 将86例Ⅰb2~Ⅱb期宫颈癌患者分为两组:A组(46例)先行动脉灌注栓塞化疗,根据化疗效果决定手术治疗或放疗;B组(40例)直接行广泛全子宫切除+盆腔淋巴结清扫术.根据MRI测量化疗前后宫颈病灶大小,计算手术出血量并统计淋巴结转移率、宫旁浸润率及阴道浸润率...

Clinical Observation of Intra-arterial Infusion Chemoembolization in Treatment of Cervical Cancer and the Effect on Cell Proliferation and Apoptosis.

Abstract] Objective To investigate mechanism and indications of neoadjuvant intra-arterial chemotherapy, according to evidence-based medicine. Methods 86 patients of cervical epidermoid carcinoma Stage Ib2-IIb were randomly divided into two groups. Group A of 46 cases had undergone neoadjuvant intra-arterial infusion chemoembolization first ,then selected radiotherapy or surgery，group B of 40 cases had undergone surgical operation directly. Proliferation antigen(Ki-67) and Apoptosis cell of cervical cancer specimens were detected for 3 groups, such as before chemoembolization（group A1） ,after chemoembolization（group A2） and direct surgery(group B),then calculate Ki-67 index(LI) and apoptotic index(AI). Results 1.Total effective rate for intra-arterial infusion chemoembolization in group A was 86.96%, when 42 cases underwent surgical operation after it. 2. The haemorrhage volume during operation in grouop A was 364.4±111.5ml, which in group B was 527.3±150.6ml. Meanwhile the hemoglobin differencing before and after operation in group A was 16.4±8.8g/L，which in group B was 24.7±10.5g/L.Both results showed that surgical bleeding of group A was less than group B(P<0.05). 3.Comparing group A and group B by lymph node metastasis rate, parametrium infiltration rate and vaginal infiltration rate, no statistical significance was found(P> 0.05). 4.LI (%) for group A1, group A2 and group B were 87.22 ± 7.55,66.67 ± 7.79, 81.13±8.07. Group A1 and group B has no significant difference(P> 0.05), but LI of group A2 was much lower than group A1 and B(P<0.05). 5.AI(%) for these 3 groups were 0.67 ± 0.21,3.56 ± 1.29, 0.83±0.27. Comparing group A1and group B, we found no significant difference(P> 0.05), but In brief AI of group A2 increased obviously than the other two groups(P<0.05). Conclrsions Intra-arterial chemoembolization on uterine cervical cancer of Ib2-IIb, can significantly reduce the size of lesions, increase opportunity for complete surgical resection of lesions, reduce the haemorrhage volume during operation significantly. Our studies suggest that intra-arterial infusion chemoembolization inhibit tumor cell proliferation and promote the role of apoptosis.