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目的:探讨新辅助化疗对局部晚期宫颈癌微血管和微淋巴管的影响及疗效。方法:选择70例ⅠB2～ⅡB期行新辅助化疗的宫颈癌组织,采用免疫组织化学方法检测其中微血管密度(microvessel density,MVD)和微淋巴管密度(lymphatic microvessel density,LMVD),并分析化疗疗效与临床病理因素的关系。结果:宫颈癌组织中MVD和LMVD水平均高于正常组织,差异均有统计学意义(P<0.001,P=0.028);MVD水平与肿瘤浸润深度有关(P=0.039),LMVD水平与鳞状细胞癌抗原(squamous cell carcinoma antigen,SCCAg)水平(P=0.017)和淋巴结转移(P=0.049)有关。化疗后MVD和LMVD均比化疗前降低,前者差异有统计学意义(P=0.019),而后者差异尚无统计学意义(P=0.176)。新辅助化疗总有效率为70.0%(49/70),总完全缓解率为21.4%(15/70);多因素分析显示,宫颈癌浸润深度是影响化疗疗效的独立因素(P=0.018,OR=0.169)。结论:新辅助化疗可有效降低局部晚期宫颈癌的MVD水平,缩小肿瘤体积。
Objective: To investigate the effect of neoadjuvant chemotherapy on the microvascular and lymphatic vessels in locally advanced cervical cancer. Methods: Seventy patients with stage ⅠB2 ~ ⅡB neoadjuvant chemotherapy were selected for cervical cancer. Immunohistochemistry was used to detect the microvessel density (MVD) and lymphatic microvessel density (LMVD). The curative effect of chemotherapy And clinicopathological factors. Results: The levels of MVD and LMVD in cervical cancer were significantly higher than those in normal tissues (P <0.001, P = 0.028). The level of MVD was correlated with the depth of tumor invasion (P = 0.039) The level of squamous cell carcinoma antigen (SCCAg) (P = 0.017) and lymph node metastasis (P = 0.049). After chemotherapy, MVD and LMVD were lower than before chemotherapy, the former difference was statistically significant (P = 0.019), while the latter the difference was not statistically significant (P = 0.176). The total effective rate of neoadjuvant chemotherapy was 70.0% (49/70) and the total complete remission rate was 21.4% (15/70). Multivariate analysis showed that the depth of invasion of cervical cancer was an independent factor affecting the efficacy of chemotherapy (P = 0.018, OR = 0.169). Conclusion: Neoadjuvant chemotherapy can effectively reduce the MVD in locally advanced cervical cancer and reduce the tumor volume.