双侧子宫动脉灌注化疗栓塞术治疗局部晚期宫颈癌的疗效观察

Clinical efficacy of bilateral uterine arterial infusion chemotherapy and embolization in cervical cancer patients and its effect on tumor markers

目的探讨双侧子宫动脉灌注化疗栓塞术在宫颈癌患者中的临床效果及对肿瘤标志物的影响。方法选取2015年1月至2019年1月间湖北省武汉市商职医院收治的拟行新辅助化疗的114例局部晚期宫颈癌患者,采用双侧子宫动脉灌注化疗栓塞术治疗的57例患者纳入A组,采用静脉全身化疗的57例患者纳入B组。观察两组患者临床疗效、手术前后肿瘤标志物水平和不良反应发生率。结果 A组患者临床缓解率为77. 2%,高于B组患者的57. 9%,差异有统计学意义(P <0. 05)。A组患者骨髓抑制和胃肠反应发生率均低于B组患者,差异均有统计学意义(均P <0. 05)。两组患者肝功能损害和末梢神经毒性发病率比较,差异无统计学意义(P> 0. 05)。治疗前,两组患者的血清癌胚抗原(CEA)、糖类抗原125(CA125)和鳞状上皮细胞癌抗原(SCC-Ag)比较,差异无统计学意义(P> 0. 05)。治疗后,两组患者CEA、CA125和SCC-Ag水平与治疗前比较均降低,且A组均低于B组,差异均有统计学意义(均P <0. 05)。结论采用双侧子宫动脉灌注化疗栓塞术治疗局部晚期宫颈癌患者,可降低肿瘤标志物水平,提高临床疗效,减少不良反应发生率,值得临床推广应用。

Objective To investigate the clinical effects of bilateral uterine arterial infusion chemotherapy and embolization in patients with cervical cancer and its influence on tumor markers. Methods A total of 114 patients with locally advanced cervical cancer who underwent neoadjuvant chemotherapy at Wuhan Business Professionals Hospital from January 2015 to January 2019 were enrolled in the study. The patients were divided into group A and group B by random number table with 57 patients in each group. Group A was treated with bilateral uterine artery infusion chemotherapy and embolization,and group B was given intravenous systemic chemotherapy. The clinical efficacy of the two groups,the tumor marker levels and the incidence of adverse reactions before and after surgery were observed. Results The clinical remission rate( RR) was 77. 2% for group A which was significantly higher than 57. 9% in group B( P < 0. 05). The incidence of bone marrow suppression and gastrointestinal reaction in group A was significantly lower than that in group B( all P < 0. 05). There was no significant difference in the incidence of liver function damage and peripheral neurotoxicity between the two groups( P > 0. 05). There were no significant differences in the levels of carcinoembryonic antigen( CEA),carbohydrate antigen 125( CA125) and sguamous cell carcinoma associated antigen( SCC-Ag) between the two groups before treatment( P > 0. 05). The levels of CEA,CA125 and SCC-Ag in the two groups were significantly lower after the treatment than before treatment with group A significantly lower than group B( all P < 0. 05). Conclusion The use of bilateral uterine arterial infusion chemotherapy for neoadjuvant chemotherapy in patients with locally advanced cervical cancer can reduce the level of tumor markers,improve clinical efficacy,reduce the incidence of adverse reactions,and is worthy of clinical application.