宫颈癌新辅助化疗敏感性的影响因素研究

Factors associated with sensitivity of neoadjuvant chemotherapy in cervical cancer

目的：探讨影响宫颈癌患者新辅助化疗（NACT）敏感性的相关因素。方法：回顾分析2011年4月至2015年2月天津市中心妇产科医院收治的106例IB2~IIB期宫颈癌患者资料,行NACT 1~3个疗程,术前评价治疗效果。分析病理类型、临床分期、肿瘤直径、组织学分级、治疗前血清鳞状上皮抗原（SCC-Ag）、血红蛋白、血小板、血小板与淋巴细胞比值（PLR）与NACT敏感性的关系。结果：NACT有效率为64.15%（68/106）。NACT有效组的手术时间、术后淋巴结转移率、宫颈深间质浸润率均低于无效组（P〈0.05）。单因素分析显示,治疗前肿瘤直径、SCC-Ag、PLR与宫颈癌NACT敏感性有关（P〈0.05）。多因素分析显示,治疗前肿瘤直径、SCC-Ag、PLR是影响宫颈癌NACT敏感性的独立危险因素（P〈0.05）。结论：治疗前肿瘤直径、SCC-Ag、PLR对宫颈癌NACT的敏感性有一定的预测价值。

Objective：To explore the effective factors for sensitivity of neoadjuvant chemotherapy（NACT） in cervical cancer. Methods：Stage IB2 to IIB disease was present in 106 patients which were all undertaken 1 - 3 courses of NACT and radical hysterectomy in our hos- pital during Apr. 2011 and Feb. 2015. Efficacy lationship of NACT sensitivky with pathological was evaluated preoperatively. To analyze the re- type, clinical stage, tumor diameter, grade of dif- ferentiation,pretreatment level of serum squamous cell carcinoma antigen （SCC-Ag）, hemoglo- bin, platelets, platelet and lymphocyte ratio （PLR）. Results：The efficiency was 64.15% （68/ 106）. Time of operation and the rate of lymph node metastasis and cervical deep stromal infil- tration in effective group was significantly lower than that in invalid group （P〈0. 05 ）. Univariate analysis showed that pretreatment tumor diameter, SCC-Ag, PLR was significantly related to NACT sensitivity （ P〈0.05 ）. Multivariate analysis showed those pretreatment tumor diameter, SCC-Ag,PLR were independently correlated with NACT sensitivity in cervical cancer （P 〈 0.05 ）. Conclusions： Pretreatment tumor diameter, SCC-Ag and PLR showed potentially predic- tive value of NACT sensitivity in cervical cancer.