长春新碱联合顺铂对Ⅰb~Ⅱb宫颈癌术前的近期疗效

Short-term curative effect of vincristine combined with cisplatin on stageⅠb-Ⅱb cervical cancer before surgery

目的探讨长春新碱联合顺铂用于Ⅰb~Ⅱb期宫颈癌术前辅助化疗对血清肿瘤标志物及近期疗效的影响。方法选取56例宫颈癌病例,采用简单随机分组将宫颈癌病例均分为观察组和对照组。对照组术前采用顺铂辅助化疗,观察组术前采用长春新碱联合顺铂辅助化疗,均治疗28 d。在化疗结束14 d后,对全部患者进行宫颈癌根治手术。观察比较2组治疗疗效、治疗前后T细胞亚群和血清肿瘤标志物表达水平,以及不良反应发生率。结果观察组病例的有效率(75.00%)显著高于对照组(53.57%),P<0.05;治疗后,观察组患者体内CD3+、CD4+以及CD4+/CD8+显著高于对照组,而CD8+则低于对照组(P<0.05);观察组血清糖类抗原125(carbohydrate antigen 125,CA125)、鳞状细胞癌相关抗原(squamous cell carcinoma antigen,SCCA)和癌胚抗原(carcinoembryonic antigen,CEA)水平低于对照组(P<0.05);观察组与对照组不良反应发生率分别为14.28%和32.14%,2组比较差异无统计学意义(P>0.05)。结论在Ⅰb~Ⅱb期宫颈癌术前,采用长春新碱联合顺铂辅助化疗,可有效提高治疗效果,增强机体的免疫力,降低宫颈癌患者血清中肿瘤标志物的表达水平,且不良反应发生率较低。

Objective To explore the effects of vincristine combined with cisplatin for adjuvant chemotherapy on serum tumor markers and short-term curative effect before stageⅠb-Ⅱb cervical cancer surgery.Methods A total of 56 patients with cervical cancer were enrolled and divided into observation group and control group by simple random grouping method.Before surgery,the control group were given cisplatin,while the observation group were given vincristine combined with cisplatin for adjuvant chemotherapy.The both groups were treated for 28 days.At the 14 th day after chemotherapy,all of the patients underwent radical surgery of cervical cancer.The curative effect,the levels of T cell subsets and serum tumor markers before and after treatment,and the incidence of adverse reactions(ADR)were compared between the 2 groups.Results The response rate of the treatment in observation group was significantly higher than that in control group(75.00%vs.53.57%)(P<0.05).After treatment,the CD3+,CD4+and CD4+/CD8+ratio in observation group were significantly higher than those in control group,while the CD8+was lower than that in control group(P<0.05).The levels of serum carbohydrate antigen 125(CA125),squamous cell carcinoma antigen(SCCA)and carcinoembryonic antigen(CEA)in observation group were lower than those in control group(P<0.05).The incidence of adverse reactions in observation group and control group were 14.28%and 32.14%,respectively,and there was no statistical significance between two groups(P>0.05).Conclusion Before stageⅠb-Ⅱb cervical cancer surgery,the adjuvant chemotherapy of vincristine with cisplatin can effectively improve the curative effect,enhance immunity and reduce the expression levels of serum tumor markers in patients with cervical cancer,with low incidence of ADR.