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目的探讨新辅助化疗联合放疗对局部晚期宫颈癌组织内血管及淋巴管生成的抑制作用及其临床疗效。方法选取2012年1月至2013年12月淮安市第一人民医院妇产科诊断及治疗的局部晚期宫颈癌患者68例,按随机数字表法分组,对照组患者(n=34)予以单纯放疗治疗,研究组患者(n=34)予以新辅助化疗联合放疗治疗,取治疗前后宫颈组织测定微血管密度(MVD)、微淋巴管密度(LMVD)和张力蛋白同源第10号染色体缺失的磷酸酶(PTEN)、血管内皮生长因子(VEGF)、内皮糖蛋白(CD105)的表达的阳性率,同时对比宫颈组织学疗效,记录两组间毒副作用及生存状况。结果对照组治疗有效率(61.76%)低于研究组有效率(91.18%),差异有统计学意义(P<0.05);与治疗前比,两组治疗后宫颈癌组织MVD、LMVD水平降低,PTEN阳性表达率升高,CD105阳性表达率降低,生活质量评分升高,差异有统计学意义(P<0.05,P<0.01);与对照组比,研究组治疗后宫颈癌组织MVD、LMVD水平降低,PTEN阳性表达率升高,VEGF、CD105阳性表达率降低,生活质量评分升高,差异均有统计学意义(P<0.05,P<0.01);研究组2年生存比例明显高于对照组(85.29%vs 61.76%,P<0.05)。两组患者均有轻度不良反应,均可耐受,对研究未产生影响。结论新辅助化疗与放疗联合治疗局部晚期宫颈癌,可以提高临床疗效,降低MVD、LMVD水平和VEGF、CD105表达的阳性率,安全性高。
Objective To investigate the inhibitory effect of neoadjuvant chemotherapy combined with radiotherapy on angiogenesis and lymphangiogenesis in locally advanced cervical cancer and its clinical efficacy. Methods Sixty-eight patients with locally advanced cervical cancer who were diagnosed and treated in Department of Obstetrics and Gynecology, First People’s Hospital of Huai’an from January 2012 to December 2013 were randomly divided into two groups according to random number table, and the control group (n = 34) (N = 34) were treated with neoadjuvant chemotherapy combined with radiotherapy. Cervical tissue microvessel density (MVD), micro-lymphatic vessel density (LMVD) and tension-protein-homologous chromosome 10-deleted phosphatase (PTEN), vascular endothelial growth factor (VEGF) and endothelium glycoprotein (CD105) expression in cervical intraepithelial neoplasia, and compare the curative effect of cervical histology. The side effects and survival status of the two groups were recorded. Results The effective rate of the control group (61.76%) was lower than that of the study group (91.18%), the difference was statistically significant (P <0.05) PTEN positive expression rate, CD105 positive expression rate decreased, quality of life scores increased, the difference was statistically significant (P <0.05, P <0.01); compared with the control group, the study group after treatment of cervical cancer MVD, LMVD levels (P <0.05, P <0.01). The 2-year survival rate of the study group was significantly higher than that of the control group (85.29% vs 61.76%, P <0.05). Two groups of patients had mild adverse reactions, can be tolerated, did not affect the study. Conclusions Neoadjuvant chemotherapy combined with radiotherapy in the treatment of locally advanced cervical cancer can improve the clinical curative effect, reduce the positive rates of MVD, LMVD, VEGF and CD105 expression, and have high safety.