吉西他滨对宫颈癌患者癌组织血管新生能力和wnt通路影响的临床观察

Clinical observation of the effects of gemcitabine on angiogenesis and wnt pathway in the cancer tissues of patients with cervical cancer

目的探究吉西他滨对宫颈癌患者癌组织血管新生能力和wnt通路的影响。方法选取2014年8月至2017年10月华北医疗健康产业集团峰峰总医院肿瘤科诊治的宫颈癌并行放化疗后手术切除的120例患者作为研究对象。使用随机数字表法将其平均分为实验组和对照组,每组60例患者。实验组患者在对照组患者治疗的基础上施加吉西他滨,对照组患者给予三维适形放疗和顺铂联合氟尿嘧啶化疗后行切除术,比较两组患者的临床疗效,化疗前后血管内皮生长因子(VEGF)家族VEGFA、VEGFC、VEGFD及病灶与健康组织外因子蛋白1(wnt1)、wnt3a、wnt8、β-链蛋白(β-catenin)水平。结果化疗前,两组患者VEGFA、VEGFC、VEGFD水平及健康组织Wnt1、Wnt3a、Wnt8、β-catenin水平比较,其差异均无统计学意义(均P>0.05)。化疗后,实验组患者治疗有效率显著优于对照组患者;两组患者VEGFA、VEGFC、VEGFD水平均显著降低,且实验组显著低于对照组;病灶组织Wnt1、Wnt3a、Wnt8、β-catenin水平均显著高于其健康组织,实验组患者病灶组织显著低于对照组患者,其差异均具有统计学意义(均P<0.05)。结论吉西他滨能够有效提高宫颈癌患者治疗有效率,降低其血管新生因子和Wnt通路相关指标水平,进而降低其癌细胞迁移、侵袭能力,值得临床推广。

Objective To investigate the effects of gemcitabine on angiogenesis and wnt pathway in cancer tissue of patients with cervical cancer. Methods 120 cases of cervical cancer treated by the Oncology Department of Fengfeng General Hospital of North China Medical and Health Industry Group from August 2014 to October 2017 were selected as the research objects. They were divided into the experimental group and the control group by random number table method, with 60 cases in each group. Patients in the control group received three-dimensional conformal radiotherapy and received chemotherapy with cisplation in combination with fluorouracil, after which the patients underwent resection. On the basis of this treatment, patients in the experimental group additionally received gemcitabine. The clinical efficacy was compared between the two groups. The levels of VEGF family's VEGFA, VEGFC, VEGFD, and the levels of wnt1, wnt3 a, wnt8, beta-catenine of both the lesion and healthy tissue were compared before and after the chemotherapy. Results Before the chemotherapy, there was no significant difference in the levels of VEGFA, VEGFC and VEGFD and in the levels of wnt1, wnt3 a, wnt8 and beta-catenin between healthy tissue of both the groups(all P>0.05). After the chemotherapy, the treatment efficiency of the experimental group was significantly better than that of the control group. The levels of VEGFA, VEGFC and VEGFD were significantly decreased in both groups, and they were significantly lower in the experimental group than in the control group. The levels of wnt1, wnt3 a, wnt8 and beta-catenin were significantly higher in the lesion tissue than in healthy tissue, and they the were significantly lower in lesion tissue of patients in the experimental group than in that of the control group(all P<0.05). Conclusions Gemcitabine can effectively improve the effective rate of patients with cervical cancer and reduce the levels of angiogenesis factors and indicators related to wnt pathway. For this reason, it can reduce the migration and invasion ability of cancer cells, so it is worthy of clinical promotion.