新辅助介入化疗在局部晚期宫颈癌治疗中的价值及对细胞因子表达的影响

[目的]探讨新辅助介入化疗在局部晚期宫颈癌治疗中的价值及对MMP-2、Fas和FasL细胞因子表达的影响.[方法]选择2011年1月至2016年1月在本院妇产科收治并确诊的60例肿瘤直径大于4cm的Ⅰb~Ⅱb期宫颈癌患者作为研究对象,随机分为A组和B组,每组30例.A组患者手术前采用动脉介入新辅助化疗及根治性手术治疗;B组患者手术前采用常规静脉化疗及根治性手术治疗,考察各组疗效及副作用.同时,采用免疫组化法检测治疗前后三组患者MMP-2、Fas和FasL细胞因子的表达情况.[结果]A组和B组有效率分别为83.33%和73.33%,A组疗效显著高于B组(χ2=2.116,P=0.045);Ⅰb期有效率显著高于Ⅱa和Ⅱb,Ⅱa显著高于Ⅱb,鳞癌患者的化疗有效率显著高于腺癌,低分化宫颈癌患者有效率显著高于中分化和高分化(P<0.05).A组中共有14例出现化疗副作用,分别为呕吐或恶心(6例)、中度贫血(2例)、下腹胀痛(4例)、脱发(2例);B组共有11例出现副作用,分别为呕吐及恶心(5例)、中度贫血(1例)、脱发(5例);两组差异无统计学意义(χ2=0.617,P>0.05);MMP-2和FasL治疗后的阳性率在A组和B组中均较治疗前显著下降,而A组和B组中Fas阳性率治疗后较治疗前显著升高(P<0.05).[结论]新辅助介入化疗在局部晚期宫颈癌治疗中的效果显著,MMP-2、Fas和FasL细胞因子与宫颈癌肿瘤细胞密切相关.

Value of Neoadjuvant Interventional Chemotherapy in the Treatment of Locally Advanced Cervical Cancer and Its Effect on Cytokine Expression

[Objective]To investigate the value of neoadjuvant interventional chemotherapy in the treatment of locally advanced cervical cancer and its effect on the expression of MMP-2,Fas and FasL cytokines.[Methods]A total of 60 cer-vical cancer patients in stage of IB ~ IIB,with tumor diameters greater than 4 cm were chosen for the study.They were randomly divided into groups A and B,each with 30 subjects.Patients in group A was treated with artery interventional neoadjuvant chemotherapy plus radical surgery,while patients in group B were treated with conventional intravenous chemotherapy plus radical surgery.The efficacy and occurrence of side effects were observed.The expression of MMP-2, Fas and FasL cytokines in two groups both before and after treatment was detected by immunohistochemistry.[Results]The effective rate of group A(83.33%)was significantly higher than that of group B(73.33%)(χ2=2.116,P =0.045).The effective rate of Ib was significantly higher than that of IIa and IIb;IIa was significantly higher than that of IIb;the effective rate of chemotherapy in patients with squamous cell carcinoma was significantly higher than that of ade-nocarcinoma;the efficiency of low differentiation of cervical cancer was significantly higher than that of middle differentia-tion and high differentiation(P <0.05).In group A,there were 14 cases of chemotherapy side effects,including vomi-ting /nausea(6 cases),moderate anemia(2 cases),hypogastrium pain(4 cases)and alopecia(2 cases).Group B had a total of 11 cases of side effects,consisting of vomiting /nausea(5 cases),moderate anemia(1 cases)and alopecia(5 ca-ses).In this regard,there were no significant differences between the two groups(χ2=0.617,P >0.05).The positive rate of MMP-2 and FasL in the group A and group B after treatment were lower than before treatment,while the positive rate of Fas in group A and group B after treatment was significantly higher than before treatment(P <0.05).There were no significant differences of the positive rates of MMP-2,Fas and FasL in control group before and after treatment (P >0.05).[Conclusion] Neoadjuvant chemotherapy is effective in the treatment of locally advanced cervical cancer. MMP-2,Fas and FasL cytokines are closely related to cervical cancer cells.