紫杉醇联合顺铂对局部晚期宫颈癌的疗效研究

Effect of Paclitaxel Combined with Cisplatin in Advanced Cervical Carcinoma

目的:研究新辅助化疗(neoadjuvant chemotherapy,NACT)紫杉醇联合顺铂方案(TP)对局部晚期宫颈癌的近期疗效,分析化疗前后细胞核增殖抗原PCNA及凋亡抑制基因Survivin的变化,探讨其对宫颈癌的治疗意义。方法:手术前行新辅助化疗的宫颈癌患者30例为研究组,直接手术的20例患者为对照组,分析近期疗效。应用免疫组化方法检测宫颈癌组织的PCNA及Sur-vivin表达,分析其改变与化疗的关系和意义。结果:①研究组TP方案的总有效率为70%;②研究组TP方案盆腔淋巴结转移率(3.3%)显著低于对照组(25.0%);③临床有效组的PCNA高表达率及Survivin阳性率在NACT后明显降低(P<0.05),临床无效组则无明显变化(P>0.05)。结论:新辅助化疗TP方案对局部晚期宫颈癌有效,可降低盆腔淋巴转移率,化疗有效者的PCNA及Survivin表达明显降低,可能成为评价TP方案疗效的指标。

Objective：To study the near curative effect of Paclitaxel and Cisplatin （TP） in the treatment of advanced cervical carcinoma, to analysis the change of PCNA and SurvMn before and after Neoadjuvant Chemotherapy （NACT） and its clinical significance. Methods：30 patients received TP before operations were chosen as study group; another 20 patients underwent operations without chemotherapy was served as control group. Their near cu- rative effect was compared. The expressions of PCNA and SurvMn were examined by means of immunohistoche- mistry and analyze the relationship with NACT. Results：①In study group, the total effective rate of TP was 70% ;②The rate of pelvic lymph node metastasis in TP group was lower than that of control group; ③ The expressions of PCNA and Survivin reduced obviously for patients who responded well to NACT, while there was no obvious change for those with poor responses. Conclusions：TP of NACT is an effective regimen in the treatment of advanced cervical carcinoma which can decrease the pelvic lymphatic metastasis. The expression of PCNA and SurvMn decreased significantly for those patients who responded well to NACT, can act as new markers in the objective evaluation of TP.