术前不同途径新辅助化疗对宫颈癌血管新生及细胞增殖的影响

Effect of different preoperative neoadjuvant chemotherapy on cervical cancer angiogenesis and cell proliferation

目的:研究全身静脉化疗和经髂内动脉灌注栓塞化疗对宫颈癌血管新生及细胞增殖的影响。方法:选择在我院接受术前新辅助化疗的65例宫颈癌患者并随机分为两组,观察组接受术前经髂内动脉灌注栓塞化疗、对照组接受术前全身静脉化疗,化疗前后测定两组血清中VEGF的含量,手术切除后测定两组患者宫颈癌组织中VEGF以及促凋亡分子、抗凋亡分子的表达量。结果:两组化疗后血清中VEGFA、VEGFC、VEGFD的含量均显著低于化疗前,且观察组化疗后的血清VEGFA、VEGFC、VEGFD含量显著低于对照组;手术切除后,观察组肿瘤组织中CD34、D2-40的荧光强度以及CD34、D2-40、VEGFA、VEGFC、VEGFD、TNFAIP8、Prdx4、Stoml2、Mcl-1、Piwil2的含量显著低于对照组,Caspase-3、Caspase7、Caspase-8、Caspase-9的含量显著高于对照组。结论:经髂内动脉灌注栓塞化疗抑制宫颈癌组织中血管及淋巴管新生、促进癌细胞凋亡的作用优于全身静脉化疗,是更为理想的宫颈癌新辅助化疗途径。

Objective：To study the effects of systemic intravenous chemotherapy and internal iliac arterial infusion chemoembolization on cervical cancer angiogenesis and cell proliferation.Methods：A total of 65 patients with cervical cancer who received preoperative neoadjuvant chemotherapy in our hospital were selected and randomly divided into two groups,the observation group received preoperative internal iliac arterial infusion chemoembolization,the control group received preoperative systemic intravenous chemotherapy,serum VEGF levels of two groups were determined before and after chemotherapy,and the expression levels of VEGF as well as pro-apoptotic and anti-apoptotic molecules in cervical cancer tissue of two groups were determined after surgical resection.Results：After chemotherapy,serum VEGFA,VEGFC and VEGFD levels of both groups were significantly lower than those before chemotherapy,and serum VEGFA,VEGFC and VEGFD levels of observation groupafter chemotherapy were significantly lower than those of control group;after surgical resection,CD34 and D2-40 fluorescence intensity as well as CD34,D2-40,VEGFA,VEGFC,VEGFD,TNFAIP8,Prdx4,Stoml2,Mcl-1and Piwil2 levels in tumor tissue of observation group were significantly lower than those of control group,and Caspase-3,Caspase-7,Caspase-8and Caspase-9levels were significantly higher than those of control group.Conclusion：Internal iliac arterial infusion chemoembolization has better effects on inhibiting angiogenesis and lymphangiogenesis in cervical cancer tissue and promoting cancer cell apoptosis than systemic intravenous chemotherapy,and is a more ideal way of neoadjuvant chemotherapy for cervical cancer.