Efficacy Study on Six Antibiotic Methods for Treating Non-Gonococcal Urethritis and Cervicitis

Objective： To analyze the efficacy of six antibiotic methods for treating non- gonococcal urethritis /cervicitis and the factors influencing efficacy. Methods： Retrospective analysis of 878 nongonococcal urethritis / cervicitis cases which received regular treatment and follow-up in our institute from 1st Jan. 2001 to 31st Aug. 2003. Results： The mean cure rate of six methods for Chlamydia trachamatis （Ct） was 57.116%. There were distinct differences among these methods for Ct treatment.The mean cure rate of six methods for Ureaplasma urealyticum （Uu） was 69.556% and there was no difference among these methods for Uu treatment. Coinfection with Ct and Uu dramatically reduced the elimination rate of these two pathogens. Conclusion： The effectiveness of treatment of these antibodies for non-gonococcal urethritis / cervicitis is not currently satisfactory. Importantly, there were many antibiotic-resistant Ct and Uu strains. The factors influencing antibiotic efficacy and mechanisms need further study.

Patterns of Relapse and Management Options in Unknown Primary Cervical Metastatic Carcinoma

Objective: To analyze the patterns of relapse and management options in unknown primary cervical metastatic carcinoma (UPCMC) as well as to discuss its treatment strategies. Methods: Clinical data of 111 cases of eligible UPCMC were retrospectively studied. Neck control, primary relapse and long-term survival were compared among different groups. Results: Primary carcinomas ultimately appeared in 12 cases (10.8%, 12/111). Neck control rate was 36.9%. Overall 5-year survival rate was 41.4%. Neck control, N stage and primary control were prognostic factors for UPCMC. Neck control was affected by N stage and whether or not comprehensive radiotherapy was administered. Conclusion: UPCMC should primarily be treated by radiotherapy except for cases with N1 or N2 insensitive to radiation. Bilateral necks radiotherapy is the optimal choice in terms of neck radiotherapy. Selective total pharyngeal irradiation is recommended for potential primary treatment.

DIAGNOSIS AND TREATMENT OF CESAREAN SCAR PREGNANCY

Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.

Diagnostic and Therapeutic Cold Knife Conization for Cervical Intraepithelial Neoplasia

OBJECTIVE of using cold （CIN）. METHODS To evaluate the diagnostic and therapeutic efficacy knife conization for cervical intraepithelial neoplasia We retrospectively analyzed 186 cases with CIN diagnosed and treated in our hospital; compared the histologic diagnoses from cervical conization and from colposcopic multiple punch biopsies, and then evaluated their postoperative histologic findings and clinical outcomes. RESULTS Of the 186 cases, there was a correlation in histologic findings between cervical conization and colposcopic multiple punch biopsies in 138 cases （74.2%）, and there was no correlation in the other 48 cases （25.8%）. Incomplete excision was performed in 8 cases （4.3%）, but the failure rate was only 1.1%; the cure rate was 98.9%. Five cases with early invasive cancer were found. Eleven patients underwent subsequent hysterectomy. The main complications associated with conization were hemorrhage and cervical stenosis. Bleeding occurred in 8 （4.3%） of the patients, and cervical stenosis occurred in 3 （1.6%）. CONCLUSION Cervical intraepithelial neoplasia was diagnosed more accurately using conization than by colposcopic multiple punch biopsies. Conization can also play an important role in the treatment for CIN. If properly performed, the procedure has a low risk of complications. It can provide an accurate histologic representation of the disease process, and be curative in most cases.

Abnormalities of uterine cervix in women with inflammatory bowel disease

AIM： To evaluate the prevalence of abnormalities of the uterine cervix in women with inflammatory bowel disease （IBD） when compared to healthy controls. METHODS： One hundred and sixteen patients with IBD [64 with Crohn＇s disease （CD） and 52 with ulcerative colitis （UC）] were matched to 116 healthy controls by age （＋/- 2 years） at the time of most recent papanicolaou （Pap） smear. Data collected consisted of age, race, marital status, number of pregnancies, abortions/miscarriages, duration and severity of IBD, Pap smear results within five years of enrollment, and treatment with immunosuppressive drugs. Pap smear results were categorized as normal or abnormal including atypical squamous cells of undetermined significance （ASCUS）, low-grade squamous intraepithelial lesion （LGSIL）, and high-grade squamous intraepithelial lesion （HGSIL）. RESULTS： The median age at the time of Pap smear was 46 （range： 17-74） years for the IBD group and matched controls （range： 19-72 years）. There were more Caucasian subjects than other ethnicities in the IBD patient group （P = 0.025）, as well as fewer abortions （P = 0.008）, but there was no significant difference regarding marital status. Eighteen percent of IBD patients had abnormal Pap smears compared to 5% of controls （P = 0.004）. Subgroup analysis of the IBD patients revealed no significant differences between CD and UC patients in age, ethnicity, marital status, number of abortions, disease severity, family history of IBD, or disease duration. No significant difference was observed in the number of abnormal Pap smears or the use of immunosuppressive medications between CD and UC patients CP = 0.793）. No definitive observation could be made regarding HPV status, as this was not routinely investigated during the timeframe of our study. CONCLUSION： Diagnosis of IBD in women is related to an increased risk of abnormal Pap smear, while type of IBD and exposure to immunosuppressive medications are not. This has significant implications for women with IBD in that Pap smear screening protocols should be conscientiously followed, with appropriate investigation of abnormal results.

Intensity-modulated radiation therapy with concurrent chemotherapy for locally advanced cervical and upper thoracic esophageal cancer

AIM： To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy （IMRT） and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer. METHODS： A retrospective study was performed on 7 patients who were definitively treated with IMRT and concurrent chemotherapy. Patients who did not receive IMRT radiation and concurrent chemotherapy were not included in this analysis. IMRT plans were evaluated to assess the tumor coverage and normal tissue avoidance. Treatment response was evaluated and toxicities were assessed. RESULTS： Five- to nine-beam IMRT were used to deliver a total dose of 59.4-66 Gy （median： 64.8 Gy） to the primary tumor with 6-MV photons. The minimum dose received by the planning tumor volume （PTV） of the gross tumor volume boost was 91.2%-98.2% of the prescription dose （standard deviation [SD]： 3.7%-5.7%）. The minimum dose received by the PTV Of the clinical tumor volume was 93.8%-104.8% （SD： 4.3%-11.1%） of the prescribed dose. With a median follow-up of 15 rno （range： 3-21 too）, all 6 evaluable patients achieved complete response. Of them, 2 developed local recurrences and 2 had distant metastases, 3 survived with no evidence of disease. After treatment, 2 patients developed esophageal stricture requiring frequent dilation and 1 patient developed tracheal-esophageal fistula. CONCLUSION： Concurrent IMRT and chemotherapy resulted in an excellent early response in patients with locally advanced cervical and upper thoracic esophageal cancer. However, local and distant recurrence and toxicity remain to be a problem. Innovative approaches are needed to improve the outcome.

Experience of endometrial stromal sarcoma with fertility conservation treatment

The paper introduced the experience of a case of recurrence of endometrial stromal sarcoma with fertility conservation treatment after full-term delivery. A 24-year-old unmarried patient who, with her increasing amount of menstruation in the late six months, had a mass in her lower-abdominal which was confirmed by B-ultrasonic diagnosis as myometrium mixed mass, was given an enucleation of uterus tumor. The pathological examination of tumor sample revealed it as lowgrade endometrial stromal sarcoma (LESS). And the patient underwent 6 cycles of chemotherapy over 8 months before she got pregnant and had a full-term delivery. But in 34 months after delivery, the disease recurred with metastatic of pelvic and peritoneal cavity and the patient had to receive comprehensive therapy. Conclusion: The unmarried young patient with stage I low-grade endometrial stromal sarcoma has the chance to preserve uterus for her pregnancy and delivery. But the using of cesarean needs do staging operation and prognosis evaluation.

Molecular mechanism of Skp2 in promoting cervical cancer HeLa cell proliferation

Objective: To explore the impact of s-phase kinase-associated protein 2 (Skp2) on cervical cancer cell proliferation and the relationship between Skp2 and expression of cell regulation factors and transcription factors. Methods: RNAi technology was used to silence Skp2 gene in HeLa cells. After interference, RT-PCR was used for detection of Skp-2 mRNA, and Western blotting and flow cytometry were used for protein expression analysis. Results: siRNA significantly inhibited HeLa cell proliferation (P<0.05) and increased HeLa apoptosis, and G1/G0 phase cells were increased significantly (P<0.01). Skp2 siRNA transfected HeLa cells effectively reduced Skp2 protein levels, while p27 and p-p53 protein levels were increased significantly. RT-PCR results showed that after interference Skp2 mRNA, c-myc mRNA and cyclin A mRNA expressions decreased significantly compared with those in control group (P<0.01), and p27mRNA expression level was significantly higher (P<0.01). Conclusion: The change of Skp2 expression affects the expression of the cell cycle protein, thus affecting proliferation and apoptosis of HeLa cells. Skp2 protein plays an important role in the progression of cervical cancer; yet the specific mechanism still needs further study.

The Analysis of High-Risk Molecular Markers for Cervical Cancer Patients under Thirty-Five

OBJECTIVE To explore molecular markers for cervical cancer in female patients below thirty-five years of age, so that the markers may be used to formulate a prognosis and to provide some useful targets for improving therapy. METHODS Pathological data were collected from 64 cervical cancer patients under the age of 35 from June, 1995 to June, 2000 in our institution. The data were retrospectively analyzed as a study group, and compared to data obtained from 90 cervical cancer cases over the age of 35 as controls who underwent treatment during the same time period. Immuno-histochemical and quantified image analyses were conducted to look for differences between the two groups in expression of survivin, p27, CD44v6, MMP-2 and TIMP-2. RESULTS The overall 5-year survival rate (65.6%) of the study group was significantly lower (P<0.05) compared to the control group (84.4%). The expression of survivin, MMP -2 and CD44v6 was much higher in the younger study group compared to the older control group, but TIMP-2 displayed higher expression in the control group (P<0.05). There was no significant difference in p27 expression between the two groups (P>0.05). CONCLUSION Young women patients with cervical cancer have a poorer prognosis compared to old women. Our study reveals that survivin, MMP-2, TIMP-2 and CD44v6 expression have a correlation with shorter 5-year survival. Improvement in the prognosis for young cervical cancer patients can be expected using biomedical therapy which targets these molecular markers.

Progress in Diagnosis and Treatment of Small Cell Carcinoma of the Cervix

Small cell carcinoma of the cervix （SCCC） belongs to the neuroendocrine carcinomas, and it is a rare gynecological tumor of high-potential malignancy. It has a poorer prognosis compared to cervical squamous cancer or adenocarcinoma, and the therapeutic regimen of the disease differs. Diagnosis is based on pathomorphological characteristics, i.e., the small and round cancer cells （oat cell） which are uniform in shape and size, with the immunohistochemical marker helpful for diagnosis. Combined therapy is first recommended, Postoperative chemotherapy with platinum/etoposide （PE）, vincristine/adriamycin/cyclophosphamide （VAC） and taxel/carboplatin （TP） can markedly improve the prognosis of early SCCC patients.

An Investigation of the Potential Malignant Characteristics of Endometriosis

OBJECTIVE To investigate the potential malignant characteristics and pathogenesis of endometriosis as well as the role of human growth hormone and epidermal growth factor receptor in the pathogenesis of malignant transformation of endometriosis. METHODS The immunohistochemical S-P method was used to examine the expression of human growth hormone and epidermal growth factor receptor in the eutopic and ectopic endometrium of 84 cases of endometriosis. RESULTS The percentage of positive cases of human growth hormone in eutopic and ectopic endometrium was 90.77% （59/65） and 85.71% （72/ 84） respectively. The percentage of positive cases of epidermal growth factor receptor in eutopic and ectopic endometrium was 81.54% （53/65） and 89.29% （75/84） respectively. The positive rate of epidermal growth factor receptor in ectopic endometrium was higher than that in the eutopic endometrium but without a statistically significant difference （P〉 0.05）. CONCLUSION Endometriosis is caused by multiple factors, which possesses some biologic features of neoplastic tissue such as invasion and metastasis. Both human growth hormone and epidermal growth factor receptor are highly expressed in eutopic and ectopic endometrium, which lead directly or indirectly to the pathogenesis of endometriosis and promote the initiation and malignant transformation of endometriosis.

Diagnosis and treatment of diverticulum of the uterus in pregnancy through hysteroscopy and methotrexate: a case report

A 27-year-old patient was diagnosed by hysteroscopy with uterine diverticulum in pregnancy and admitted to the hospital. Under the guidance of hysteroscopy combined with methotrexate, the scraping of the uterus was done and operation successfully completed. The management of this case showed that hysteroscopy was a kind of valuable approach to the diagnosis and treatment of uterine diverticulum and curettage of the uterus under hysteroscope combined with drug was a safe, effective and conservative treatment.

Expression and Clinical Significance of HMGB1 and RAGE in Cervical Carcinoma

OBJECTIVE To study the expression level and clinical significance of HMGB1 and RAGE in cervical squamous epithelial carcinoma. METHODS Real time quantitative polymerase chain reaction （qRT-PCR） was employed to examine the expression of HMGB1 （high mobility group box protein1）, and RAGE （receptor for advanced glycation endproducts） in 60 cervical squamous epithelial carcinomas （CSEC）, their paraneoplastic tissues （PS） and 30 normal cervix tissues （NCS）. RESULTS The expression of HMGB1 in the CSEC samples and PS was similar （P〉0.05）, but higher compared to NCS （P〈0.05）. Overexpression of HMGB1 in the CESC tissues was significantly correlated with the tumor （P〈0.05）, and the presence of metastasis （P〈0.01）, but not correlated with the tumor diameter or tumor grade.RAGE expression was not significantly different among these tissue types, and showed no significant correlation with the the tumor stage, diameter or grade. But there was a significant positive correlation between RAGE expression and CSEC metastasis. CONCLUSION The results suggest that HMGB1 may be related to the proliferation, progression and metastasis of CSEC. The relationship of HMGBI/RAGE may be of importance for CSEC metastasis. HMGB1 presents a new potential gene target for prevention and treatment of CSEC. Study of HMGBI/RAGE expression will offer an experimental foundation for understanding the pathogenesis of CSES.

Clinical study of paclitaxel plus cisplatin in the treatment of recurrent cervical cancer

Objective: To observe the efficacy and toxicities of paclitaxel plus cisplatin in the treatment of recurrent cervical cancer. Methods: Twenty-three patients with a diagnosis of recurrent cervical cancer were eligible. Three-weekly chemo- therapy regimen consisted of paclitaxel 135–150 mg/m2 infusion for 3 h on day 1, cisplatin 25 mg/m2 infusion on day 1 to 3. All patients received at least two cycles treatment. Results: The response rates was 47.8%, including CR 2 cases (8.7%), PR 9 cases (39.1%). The major toxicity included neutropenia, nausea vomiting, arthralgia, myalgia and alopecia. Conclusion: Paclitaxel combined with cisplatin is an effective therapy with acceptable adverse reactions for recurrent cervical cancer.

Synchronous primary cancers of the endometrium and ovary： review of 43 cases

Objective： To investigate the clinical and pathological characteristics, treatment methods, and prognosis of synchronous primary cancer of the endometrium and ovary. Methods： The clinical data of 43 patients with synchronous primary cancer of endometrium and ovary were retrospectively reviewed. The survival was calculated by Kaplan-Meier method and compared using the log-rank test. Results： The median age of the patients at diagnosis was 49 years （range, 28-73 years）. The most common symptoms were abnormal vaginal bleeding （69.8%） and abdominal or pelvic pain （44.2%）. Pelvic masses were found in 39.5% of the patients and enlarged corpus in 27.9% at physic examination, while pelvic masses were found in 67.4% of the 43 patients （29 cases） and thickening or abnormal endometrium in 23.3% （10 cases） during ultrasound examination. Of 25 patients examined by CT/MRI, pelvic masses were found in 13 cases and enlarged uterus in 11 cases. All 15 patients who underwent endometrial biopsies were proven to have endometrioid carcinomas. Serum CA125 level was found to be elevated in 22 of the 34 examined cases （64.7%） with median value 500 U/mL （range, 39-3439 U/mL）. FIGO stages of endometrial carcinomas： IA 18 cases, IB 20 cases, IC 2 cases, and ⅡA 3 cases; Stages of ovarian carcinomas： IA 19 case, IB 4 cases, IC 7 cases, Ⅱ 4 cases, and ⅢC 9 cases. Twenty-four patients （55.8%） were in stage I both endometrial and ovarian carcinomas. Thirty-one patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with omentectomy and appendectomy, meanwhile, 12 patients had pelvic lymph nodes dissection. Thirty-eight of the 43 patients （88.4%） had a pathologically proven endometrial adenocarcinomas. The predominant ovarian histologies were endometrioid or mixed tumors with endometrioid components （30/43, 69.8%）. Postoperatively, 26 patients （60.5%） received adjuvant chemotherapy alone, 12 had chemotherapy plus radiotherapy, only one patients had radiation alone and the remaining 4 cases received no adjuvant treatment. The 3-year and 5-year survival rates of the group were 87.4% and 71.1% respectively. The 3-year and 5-year survival rates of patients with endometrioid carcinoma at both endometrial and ovarian were higher than that of those with non-endometrioid or mixed histologic subtypes （93.8%, 82% vs 79.7%, 69%）. The 3-year and 5-year survival rates of patients with early stages disease were better than those of other patients （93.3%, 93.3% vs 69.7%, 36.7%）. Recurrence developed in 15 patients （34.9%）. It was showed by univariate analysis that lower CA125 level, early FIGO stage, and adjuvant chemotherapy plus radiotherapy significantly and positively affected the 5-year survival rate, while only early FIGO stage and chemotherapy plus radiotherapy were revealed by multivariate analysis as independent prognostic factors. Conclusion： Synchronous primary cancers of the endometdum and ovary were different from either the primary endometrial or ovarian cancer, while usually it can be detected in early stage with a good prognosis. The impact of the CA125 level on prognosis needs to be further studied. Surgery treatment alone may be enough for early stage patients. Chemotherapy plus radiotherapy may be necessary for advanced patients.

Individualized misoprostol dosing for labor induction or augmentation: A review

Cesarean birth rates are greater than 20% in many developed countries. The main diagnoses contributing to the high rate of cesarean births in nulliparous women are dystocia and prolonged labor. Traditionally, a policy of vaginal dinoprostone for the treatment of unripe cervix or early amniotomy with oxytocin administration for a ripened cervix has been associated with a modest reduction in the rate of cesarean births due to arrest disorders. However, the course of vaginal dinoprostone is tedious and oxytocin should be administered through an infusion pump, which may be inconvenient in certain settings. Because misoprostol has powerful uterotropic and uterotonic effects, and has become a common agent used in the practice of obstetrics and gynecology, the United States Food and Drug Administration removed the absolute contraindication of the drug during pregnancy from its label in April 2002. However, excessive uterine contractility resulting in tachysystole or fetal distress is always a concern with the oral or vaginal use of fixeddosage misoprostol. Therefore, misoprostol should be administered with caution to ensure that fetal hypoxia does not occur. A pilot trial examining the use of very small, frequent, titrated oral misoprostol dosages administered every 2 h was fi rst conducted by Hofmeyr et al in 2001. Given women's different metabolisms and responses tomisoprostol, another method of titrating individualized oral misoprostol with dosing administered every hour relative to uterine response was then developed by Cheng in 2006. Based on previous studies, this titration method is potentially an ideal alternative to traditional dinoprostone, oxytocin or the previously established misoprostol dosing method for labor induction or augmentation.

Clinical outcome following radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer

Objective： To estimate the impact of parametrial infiltration and lymph node metastasis on clinical outcome in women with early-stage cervical cancer following radical hysterectomy and pelvic lymphadenectomy. Methods： Clinical records and pathologic slides of 532 patients with early-stage cervical cancer （330 Ib and 202 Ila） treated with radical hysterectomy and pelvic lymphadenectomy were reviewed. The study group comprised 520 patients with squamous call carcinoma and 12 patients with adenocarcinoma of the cervix. Median follow-up time was 67 months. The association among the various histopathologic predictors of outcome was determined with analysis. The influence of the predictors on outcome was examined with log rank survival methods and the Cox regression model. Results： FIGO stage, histologic type, tumor size, depth of invasion, parametdal infiltration, lymph node metastasis, and remote metastasis were identified as significantly biologically relevant and therefore were included as candidate predictors in multivariate analysis. In particular, parametrial infiltration and lymph node metastasis were found to be simultaneous predictors of death on multivariate analysis （P 〈 0.05）. After controlling for these two factors, the other variables considered were not statistically significant up to a two-way interaction. Conclusion： Presence of parametdal infiltration and/or lymph node metastasis in women with early-stage cervical cancer is an independent poor prognostic factor. In addition, the relatively poor survival of women with more than one lymph nodes identified with cancer cells.

Ampullary adenomyoma presenting as acute recurrent pancreatitis

Adenomyoma is a term generally applied to nodular lesions showing proliferation of both epithelial and smooth muscle components. Despite its benign nature,ampullary adenomyoma is usually presented as biliary obstruction. Most cases are misdiagnosed as carcinoma or adenoma by preoperative endoscopic or radiologic procedure. Therefore,it is frequently treated with extensive surgery. To our knowledge,this is the first reported case in English literature of adenomyoma located in the peripancreatic orifice resulting in intermittent pancreatic duct obstruction and recurrent pancreatitis diagnosed by the endoscopic piecemeal resection.

Overexpression of p53 Gene in Esophageal and Cervical Cancer and the Relationship with Radiotherapy Effects

Objective :To investigate the relationship between p53 -protein overexpression in esophageal and cervical squamous cell cancer and their clinical radiosensitivity. Methods: The immuno-histochemical assays were done for 52 cases with esophageal and cervical squamous cell cancer. The relationship between the assay results and short-term radiotherapy was investigated. Results: p53 overexpression was 52. 38% and 35. 48% respectively, in esophageal cancer and cervical cancer; p53 over-expression in high differentiated squamous cell cancer was lower than those in moderate and poor differentiated cases(P<0. 05). There was no relationship between p53 overexpression and stages(P> 0. 05). In the cases of cervical cancer, p53 overexpression had the less short-term effect(P< 0. 05), and In esophageal cancers, there was no relationship with radiotherapy effect(P>0. 05). Conclusion:This study suggests that y53 gene lias the certain relationship with tumor radiosensitivity.

Comparison of different treatment regimens for ⅠB2 and ⅡA2 cervical cancer

Objective： The aim of this study was to explore the difference of long-term prognosis of different treatment regimens in patients with stage IB2, IIA2 cervical Cancer. Methods： From August 1995 to September 2005, radical hysterectomy was chosen as primary treatment regimen for 122 patients （group A）, 85 patients underwent radical hysterectomy after ef- fective neoadjuvant therapy （group B）, and 98 patients received surgery after ineffective preoperative therapy （group C）. All patients received postoperative therapy. Results： Atotal of 305 patients were analyzed. The maximum diameter of tumor was largest in group B, while the pathological risk factors （cervical infiltration, positive surgical margins） were in the lowest propor- tion. The 5-year mortality rate and relapse rate of group B were the highest, and the overall survival （OS） and progression-free survival （PFS） were the shortest （P 〈 0.05）. No significant difference of long-term survival was found in group C and group A. No difference was found in the surgical of three groups. Large tumor more than 5.5 cm had higher effective ratio of treatment than those 5.5 cm or less. Patients received effective preoperative radiotherapy had better long-term prognosis than those received chemotherapy or radiochemotherapy. Conclusion： neoadjuvant treatment using for patients with IB2, IIA2 cervical cancer is effective in reducing risk factors of pathological, but it could not improve the long-term survival. The indications of adjuvant therapy after surgery should be reconsidered. Those tumors of diameter 5.5 cm or less response poor to neoadjuvant treatment, and no improvement of survival was found, so direct surgical treatment is suggested for these patients. Radiotherapy is a better choice of preoperative treatment.