宫颈癌顺铂化疗联合放疗的疗效与RRM1表达水平的相关性研究

Study of the Relationship Between the Efficacy of Cisplatin Chemotherapy in Combination with Ra- diotherapy and Expression levels of RRM1 in Cervical Cancer

【目的】探讨顺铂化疗联合放疗方案在宫颈癌临床治疗中的应用价值及临床疗效与核苷酸还原酶M1亚基（RRM1）表达水平的关系。【方法】随机数字表法将98例宫颈癌患者分为A、B组各49例；B组给予单纯盆腔外照射联合腔内近距离照射放疗方案；A组在B组基础上联合顺铂单药化疗方案。比较两组近期疗效、毒副反应率差异，记录其治疗前后肿瘤最大横断直径及宫颈病变组织RRM1表达变化情况。将A组按照近期疗效分为优良组和中差组，比较其宫颈病变组织RRM1表达情况差异，Pearson相关性分析法分析临床疗效与宫颈病变组织RRM1表达水平的关系。【结果】A组总治疗有效率、Ⅲ～Ⅳ度胃肠道反应发生率及Ⅰ～Ⅱ度骨髓抑制、放射性膀胱炎、放射性直肠炎发生率均明显高于B组（P〈0．05）。治疗后，A、B两组肿瘤最大横断直径及RRM1高表达率均较治疗前明显降低，且A组〈B组（P均〈0．05）。优良组宫颈病变组织RRM1低表达率为57．7％，显著高于中差组的16．7％（P〈0．05）。Pearson相关分析结果显示，宫颈癌患者顺铂化疗联合放疗方案的疗效与宫颈病变组织RRM1低表达呈正相关（P〈0．05）。【结论】顺铂化疗联合放疗方案对提高宫颈癌患者近期疗效具有积极影响，其疗效同宫颈病变组织RRM1低表达率成正相关。

[Objective]To explore the application value of cisplatin chemotherapy combined with radiotherapy in the treatment of cervical cancer, and to analyze the relationship between clinical efficacy and expression levels of ribonueleotide reduetase M1 （RRM1） in patients with cervical cancer. [Methods]Ninety-eight patients with cervical cancer were divided into group A and group B by the random number table method, 49 cases in each group. Group B was given pelvic external radiotherapy combined with brachytherapy. On that basis, group A was given cisplatin chemotherapy. The short-term effects and incidence of side effects were compared between the two groups, and changes of the maximum transverse diameter of tumor and expression of RRM1 in cervical lesions before and after the treatment were recorded. According to short-term effects, Group A was further divided into＇the good to excellent and poor to medium groups. The expression of RRM1 in cervical lesions was compared between the two groups, and Pearson correlation analysis was used to analyze the relationship between the clinical effect and expression of RRM1 in cervical lesions. [Results]The overall effective rate, incidence rates of Ⅲ～Ⅳ level gastrointestinal reactions, Ⅰ～Ⅱ level bone marrow suppression, radiocystitis, and factitial proetitis in group A were significantly higher than those in group B （ P 〈0.05）. After treatment, the maximum transverse diameter of tumor and RRM1 high expression rates were significantly lower than those before treatment, and those in group A were lower than group B （ P 〈0.05）. The RRM1 low expression rate in excellent and good group was significantly higher than that in the medium and poor group （57.7% vs 16.7%） （P 〈 0.05）. Pearson correlation analysis showed that the clinical effect of cisplatin chemotherapy combined with radiotherapy was positively correlated with RRM1 low expression in cervical lesions （ P 〈0.05）. [Conclusion]Cisplatin chemotherapy combined with radiotherapy improves the short-term effects of patients with cervical cancer, and its efficacy is inversely correlated with RRM1 expression.