PB方案在宫颈癌介入化疗中的疗效观察及对Wee1表达的影响

Application Of Cisplatin Combined With Bleomycin In Interventional Chemotherapy For Cervical Cancer

目的：研究PB方案（顺铂DDP、博莱霉素BLM），并了解其对Wee1蛋白表达的影响。方法：1、用PB方案对64例ⅠB～ⅡB期宫颈癌病人进行介入化疗，观察化疗前后宫颈肿瘤体积变化及化疗后反应，评价介入化疗的效果。2、比较介入化疗后手术患者（观察组）与直接手术患者（对照组）术中情况及术后病理情况，评价介入化疗的近期疗效。3、测定介入前后Wee1表达的变化，及与临床病理的关系，了解PB方案对Wee1的影响。结果：PB方案介入化疗的有效率（CR＋PR）为87．5％，缓解率为96．9％，34．4％出现了发热反应。未见其他明显不良反应。试验组和对照组手术时间分别为（2．92±0.3）h和（3．28±0．55）h，术中出血量分别为（453．1±131．9）mL和（542．8±5．6）mL，两组在手术时间和术中出血量方面差异有统计学意义（P〈0．05），两组术后在盆腔淋巴结转移、脉管浸润、宫旁浸润及阴道切缘受累方面差异均有统计学意义（P〈0．05）。PB方案介入化疗后，Wee1的表达较介入化疗前显著降低，差异有统计学意义（P〈0．05），和临床分期、病理类型、淋巴结转移及病理分级无关，差异无统计学意义（P〉0．05）。结论：PB介入化疗方案有效、低毒，对ⅠB～ⅡB期宫颈癌治疗具有较好的疗效，PB方案是值得推广的介入化疗方案，Wee1蛋白有望成为监测PB方案介入化疗疗效的指标。

Objective： To investigate the interventional Chemotherapy of cisplatin combined with bleomycin （PB） in Carcinoma of Uterine Cervix, and to study the effect of the expression of Weel protein. Methods： 1：64 patients with carcinoma of the uterine cervix, stage Ⅰ B -Ⅱ B, were treated with interventional Chemotherapy of PB, and response and toxicity were observed to evaluate the effect and security of PB. 2： Compared intraoperative situation and Postoperative pathological condition in patients who received radical hysterectomy directly.3： Detected the Weel expression changes before and after intervention to investigate the effect of Weel PB scheme and the clinical pathology. Results： The efficient （CR ± PR） of PB scheme intervention chemotherapy was 87.5%, alleviate rate was 96.9%, heating reaction 34.4%, and there was no the other obvious adverse reaction. The surgical operation time of the treatment group and control group was （2.92± 0.3） h and （3.28 ± 0.55） h respectively, and intraoperative amount of bleeding was （453.1± 131.9） ml and （542.8± 75.6） mL. The operation time and intraoperative amount of bleeding of the two groups were statistically significant differences （P〈 0.05）. The differences in the fields of metastasis of pelvic lymph node, vascular infiltration, infiltration of palace side and vaginal cutting edge involvement were statistically significant （P〈 0.05）. After the PB scheme intervention chemotherapy, the expression of Weel was significantly lower than before （P〈0.05）, and it had nothing to do with the clinical stage, pathological type, lymph node metastasis and pathology classification, and the ,difference was not statistically significant （P〉0.05）. Conclusion： PB scheme is an effective, low poison scheme, also it has good curative effect for Ⅰ B - Ⅱ B stage cervical cancer, it is worth to be popularized, Weel protein is expected to become the monitoring curative effect index for the PB scheme.