紫杉醇联合奈达铂动脉介入栓塞治疗宫颈鳞癌的疗效及其对微血管和微淋巴管密度的影响

Clinical efficacy of artery interventional embolization with combination of paclitaxel and nedaplatin in the treatment of cervical squamous cell carcinoma and its influence on the micro-vessel density and lymph vessel density

目的探讨紫杉醇联合奈达铂动脉介入栓塞治疗宫颈鳞癌的疗效及其对组织微血管和微淋巴管密度的影响。方法选取2007年3月至2012年6月我院诊治的84例宫颈鳞癌患者为研究对象,按随机数字表法分为紫杉醇＋奈达铂静脉滴注化疗组（对照组）和紫杉醇＋奈达铂动脉介入栓塞化疗组（栓塞组）,每组42例。分别比较两组患者的近远期临床疗效及微血管密度（Micro-vessel density,MVD）和微淋巴管密度（Lymph vessel density,LVD）的水平。结果对照组和栓塞组的总体治疗有效率分别为59.52%和80.95%,栓塞组明显高于对照组（χ^2=4.613,P=0.032）,但两组患者的疾病控制率和不良反应发生率比较差异无统计学意义（χ^2=0.718,P=0.397;χ^2=1.248,P=0.264）;随访结果显示,栓塞组1年、2年和3年生存率分别为50.00%、38.10%和23.81%,均略高于对照组,但两组间比较差异均无统计学意义（P〉0.05）;而且,两组患者的局部复发率与转移率、平均生存时间比较差异也无统计学意义（P〉0.05）;治疗后,两组患者的LVD和MVD均明显下降（P〈0.05）;与对照组相比,栓塞组患者LVD和MVD值的下降幅度更为明显（P〈0.05）。结论动脉介入栓塞治疗对宫颈鳞癌的近期临床效果较静脉滴注化疗的方式更显著,且可明显降低MVD和LVD的水平。

Objective To explore the clinical efficacy of artery interventional embolization with combination of paclitaxel and nedaplatin in the treatment of cervical squamous cell carcinoma and its influence on the micro-vessel density（ M VD） and lymph vessel density（ LVD）. Methods Eighty-four cases of cervical squamous cell carcinoma patients in our hospital were selected as the research object from M arch 2007 to June 2012. They were randomly divided into paclitaxel ＋ nedaplatin intravenous infusion group（ control group） and paclitaxel ＋ nedaplatin artery embolization group（ embolization group） according to the different treatment,42 cases in each group. The short-term and long-term clinical efficacy,M VD and LVD levels were compared between the two groups. Results The overall treatment efficiency rate of control group and embolization group were 59. 52% and 80. 95%,and the rate of embolization group was significantly higher than that of control group（ χ^2= 4. 613,P = 0. 032）; However,there was no significant difference in the disease control rate and adverse reaction incidence rate between the two groups（ χ^2= 0. 718,P = 0. 397; χ^2= 1. 248,P = 0. 264）. Follow-up results showed that the 1,2 and 3-year survival rate of embolization group was 50. 00%,38. 1%and 23. 81%,no significant diffrence was observed between the two groups（ P〉0. 05）. Moreover,there was no significant difference in the local recurrence rate,metastasis rate and average survival time between the two groups（ P〉0. 05）. After treatment,the levels of LVD and M VD in the two groups were significantly decreased（ P〈0. 05）. Compared with control group,the levels of LVD and M VD in embolization group were declined more sharply（ P〈0. 05）.Conclusion Arterial interventional embolization has better short-term clinical efficacy in the treatment of cervical squamous cell carcinoma than intravenous infusion chemotherapy,and it can significantly reduce the levels of LVD and M VD.