宫颈鳞状上皮癌化疗前后SCC、Ki-67和核分裂数的变化

Neoadjuvant chemotherapy with nedaplatin, ifosfamide, and peplocycin for locally advanced squamous cell carcinoma of cervix

目的 :探讨宫颈鳞状上皮癌化疗效果与组织标本中的核分裂数、 Ki- 6 7及血清 SCC值的关系。方法 :以肿瘤直径大于 4 cm的宫颈鳞状上皮癌患者 1 2例 ( b期 :3例 , 期 :9例 )为对象 ,采用奈得铂、异环磷酰胺、硫酸培洛霉素 (SIP疗法 )治疗 1～ 2个疗程 ,MRI判断疗效 ;采用 HE染色法、免疫组化法 (L SAB法 )及放射免疫法测量组织标本中的核分裂数、 Ki- 6 7及血清 SCC值。结果 :1 2例患者治疗 1个疗程 (6例 )或 2个疗程 (6例 )后 ,有效 7例 ,无效 5例 ,有效率 5 8.8% ,有效病例 1疗程结束时肿瘤体积较治疗前明显缩小 ,血清SCC值明显降低 ,组织核分裂数 1疗程后减少 ,Ki- 6 7无明显变化 ;无效病例组织核分裂数 1疗程后无明显变化 ,Ki- 6 7及血清 SCC有增加倾向。结论 :1疗程结束后 MRI、血清 SCC值、组织标本中的核分裂数、 Ki- 6

Objective To evaluate the efficacy of neoadjuvant chemotherapy (NAC) with nedaplatin, ifosfamide and peplomycin (SIP) for patients with locally advanced squamous cell carcinoma of cervix, and to determine whether or not the mitotic index and the Ki 67 labeling index (LI) obtained from biopsy specimens were useful as predictors of NAC response. Methods Twelve cases (stage Ib:3 and II:9) of cervical carcinoma with more than 4 cm in diameter were treated with 1 to 2 courses of SIP therapy followed by surgery. The response to SIP was measured by magnetic resonance imaging (MRI). The relationship of response and serum SCC, and the changes of mitotic index (MI) and the Ki 67 LI in the biopsy specimens were investiged before and after SIP therapy. Results Seven cases resulted in partial response (PR) and 5 cases did not change (NC), the effective rate was 58 8%. In cases with PR, tumor size reduced markedly after the first course of SIP and serum SCC decreased. MI values in PR cases decreased, and Ki 67 LI was unchanged. On the other hand, in NC cases, MI values did not decrease and Ki 67 LI tended to increase. Conclusion NAC with nedaplatin, ifosfamide and peplomycin was effective for patients with locally advanced squamous cell carcinoma of cervix. Alterations of MRI, serum SCC, MI and Ki 67 LI can be predictors for NAC.