宫颈癌新辅助化疗近期疗效及病理学改变

Clinical Effects and Histopathological Changes of Cervical Cancer Following Neoadjuvant Chemotherapy

[目的]观察子宫颈癌单疗程新辅助化疗后的近期疗效及病理学改变。[方法]40例ⅠIb2～Ⅱb期宫颈癌病例,给予单疗程新辅助化疗(NACT),化疗前后作B超、病理学检查及c-erbB-2、p53、nm23、VEGF免疫组化检测。[结果]有效率(RR)52.5%(21/40),其中完全缓解(CR)3例(7.5%),部分缓解(PR)18例(45.0%),无变化(NC)19例,无进展(PD)病例。化疗后手术切除率92.5%(37/40)。化疗后瘤体缩小或消失,瘤细胞变性、坏死、出血。淋巴结内转移肿瘤亦呈上述改变。化疗后VEGF表达降低,c-erbB-2、p53、nm23表达无变化。[结论]宫颈癌单疗程NACT近期临床疗效明显,能引起原发灶及转移灶肿瘤细胞坏死,肿瘤生长受抑制。

[Purpose]To investigate clinical effects and histopathological changes in cervical cancer following a single course of neoadjuvant chemotherapy （NACT）. [Methods] B-uhrosound, histopathological and immunohistochemical examination including markers c-erbB-2,p53,nm23,VEGF were carried out in 40 cases with cervical cancer stage Ⅰb2-Ⅱb bcfore and 1 course NACT.[Results] Response rate （RR） was 52.5%（21/40）, with CR, 7.5%（3/dO）;PR, 45.0%（18/40）; NC,19/dO;and PD, O. After NACT, resection rate of 92.5%（37/40） was achieved and cancer volum decreased or disppeared, degeneration, necrosis, and hemorrhage in tumor tissue, and metastatic lymph nodes were found. The expression of VEGF decreased significantly, but the other markers such as c-erbB-2, p53, nm23 had no significant change after chemotherapy. [Conclusion] One course of NACT is effective to cervical cancer, and can cause necrosis both in primary cancer and metastatic lymph nodes, and inhibits the growth of tumor.