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目的探讨重组人5型腺病毒在宫颈癌动脉灌注化疗栓塞中的疗效。方法选择2008年6月至2014年12月青岛市立医院收治的经病理证实为ⅠB2~ⅡB期宫颈癌患者92例,随机分为两组,47例为重组人5型腺病毒及奈达铂化疗栓塞组(研究组),45例为奈达铂化疗栓塞组(对照组)。84例患者于3~4周后行手术治疗。比较两组动脉化疗栓塞后病灶缩小情况,鳞状细胞癌抗原(SCC-Ag)、高危人乳头瘤病毒(HR-HPV)水平变化,手术情况,术后病理及不良反应。结果动脉灌注化疗栓塞前后研究组与对照组病灶缩小有效率分别为89.36%和84.44%,差异无统计学意义(χ2=0.49,P=0.484);SCC-Ag下降率分别为78.72%和64.44%,差异无统计学意义(χ2=2.31,P=0.128),HRHPV下降率分别为57.45%和28.89%,差异有统计学意义(χ2=7.63,P=0.006);术中出血量(t=3.57,P<0.001)、脉管瘤栓(χ2=7.11,P=0.008)明显减少,而淋巴结阳性(χ2=0.70,P=0.404)、神经侵袭(χ2=1.74,P=0.188)及宫旁浸润率(χ2=1.30,P=0.254),差异无统计学意义;两组动脉化疗栓塞后高热的发生率差异具有统计学意义(χ2=9.21,P=0.002)。结论重组人5型腺病毒用于宫颈癌动脉灌注化疗栓塞,可一定程度上利于后续手术操作,增强疗效,且无明显不良反应,是宫颈癌治疗研究领域中一个值得提倡的方法。
Objective To investigate the efficacy of recombinant human adenovirus type 5 in the treatment of cervical cancer with chemoembolization. Methods Ninety-two patients with pathologically confirmed stage IIB2-IIB cervical cancer who were admitted to Qingdao Municipal Hospital from June 2008 to December 2014 were randomly divided into two groups, 47 were recombinant adenovirus type 5 and nedaplatin Embolism group (study group) and 45 cases of nedaplatin chemotherapy and embolization group (control group). Eighty-four patients underwent surgery 3 to 4 weeks later. The lesion size, SCC-Ag and HR-HPV levels were compared between the two groups after arterial chemoembolization. The operative conditions, postoperative pathology and adverse reactions were compared between the two groups. Results The effective rates of lesion reduction in study group and control group before and after arterial chemoembolization were 89.36% and 84.44%, respectively, with no significant difference (χ2 = 0.49, P = 0.484). The decreasing rates of SCC-Ag were 78.72% and 64.44% , The difference was not statistically significant (χ2 = 2.31, P = 0.128), HRHPV decreased rates were 57.45% and 28.89%, the difference was statistically significant (χ2 = 7.63, P = 0.006); blood loss (t = 3.57 (Χ2 = 0.70, P = 0.404), neurological invasion (χ2 = 1.74, P = 0.188) and paracancerous infiltration (Χ2 = 1.30, P = 0.254). There was no significant difference between the two groups (χ2 = 9.21, P = 0.002). Conclusion Recombinant human adenovirus type 5 for arterial infusion of chemoembolization of cervical cancer can be benefit to follow-up operation to some extent, and enhance the curative effect without obvious adverse reactions, which is a worthy advocate in the field of cervical cancer treatment.