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目的探讨新辅助化疗治疗宫颈癌对细胞增殖与凋亡的影响,从而了解新辅助动脉化疗的作用机制,为宫颈癌的治疗提供参考。方法 52例Ib-IIb期宫颈癌患者平分两组,观察组施行动脉灌注栓塞化疗后手术,对照组直接手术治疗,观察临床疗效。分别记录两组手术病例的术中出血量,并作比较;同时检测动脉灌注栓塞化疗前、后及直接手术患者的肿瘤细胞增殖指数(Ki-67)及凋亡指数(AI)。结果观察组宫颈癌动脉灌注栓塞化疗总有效率为80.8%,对照组术后须行放疗或化疗者20例,占76.9%。观察组手术病例手术出血量为(362.5±11.5)ml,对照组手术出血量为(524.5±15.0)ml,两组比较差异有统计学意义(P<0.05)。观察组动脉化疗前活检标本,Ki-67指数(%)为(67.5±76),对照组直接手术病理标本,Ki-67指数(%)为(80.1±8.5)。观察组AI(%)为(3.5±1.3),对照组检测AI(%)为(0.8±0.3)。结论 Ib-IIb期宫颈癌行新辅助动脉灌注栓塞化疗,可显著缩小病灶体积,从而提高患者生活质量。可明显减少手术中出血量,有利于患者康复。同时促进肿瘤细胞增殖显著下降、凋亡显著增加,提示动脉化疗有抑制肿瘤细胞增殖、促进凋亡的作用。
Objective To investigate the effect of neoadjuvant chemotherapy on the proliferation and apoptosis of cervical cancer in order to understand the mechanism of neoadjuvant arterial chemotherapy and provide a reference for the treatment of cervical cancer. Methods Fifty-two patients with stage Ib-IIb cervical cancer were divided into two groups. The patients in the observation group underwent arterial infusion and chemoembolization after operation and the control group received direct surgical treatment. The clinical efficacy was observed. The blood loss of the two groups were recorded and compared. The Ki-67 and AI of the patients before and after arterial infusion embolization and direct surgery were also measured. Results The total effective rate of arterial infusion and embolization chemotherapy for cervical cancer was 80.8% in the observation group. Twenty patients (76.9%) required radiotherapy or chemotherapy in the control group after operation. The operative blood loss in the observation group was (362.5 ± 11.5) ml, while that in the control group was (524.5 ± 15.0) ml. There was significant difference between the two groups (P <0.05). The Ki-67 index (%) was (67.5 ± 76) in the observation group before biopsy, while the direct pathological specimen and the Ki-67 index (%) in the control group were (80.1 ± 8.5). The AI (%) in the observation group was (3.5 ± 1.3) and the AI (%) in the control group was (0.8 ± 0.3). Conclusions Neoadjuvant arterial infusion embolization chemotherapy in patients with stage Ib-IIb cervical cancer can significantly reduce the volume of lesions and improve the quality of life of patients. Can significantly reduce the amount of bleeding during surgery, is conducive to patient rehabilitation. At the same time promote the proliferation of tumor cells decreased significantly, a significant increase in apoptosis, suggesting that arterial chemotherapy inhibit tumor cell proliferation and promote apoptosis.