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目的:探讨两种新辅助化疗(NACT)对宫颈癌微淋巴管密度和血管内皮生长因子表达的影响及疗效。方法:选择60例Ⅰb2-Ⅱb期宫颈鳞癌患者随机分为两组,分别行全身静脉化疗和髂内动脉栓塞灌注化疗,通过免疫组织化学法和实时定量PCR法,检测两种途径NACT前后的局部宫颈癌组织微淋巴管密度(LMVD)和血管内皮生长因子-A,C,D(VEGF-A,C,D)的表达量,并分析两种NACT疗效与临床病理因素的关系。结果:1VEGFA,C,D在癌症组织表达量明显高于正常组织。2经静脉化疗后,宫颈癌组织中VEGF-D治疗后的表达量低于治疗前(P<0.05),VEGF-A,C在治疗前后的表达量无明显变化;经动脉灌注化疗后,宫颈癌组织中VEGF-C,D治疗后的表达量明显低于治疗前(P<0.05),VEGF-A的表达量在治疗后也有所下降,但无统计学意义(P>0.05)。3静脉化疗和动脉灌注化疗均降低了宫颈癌组织内的LMVD,动脉灌注化疗降低程度更显著(P<0.05)。4两组患者均达到明显的近期临床缓解,动脉灌注化疗组患者的疗效优于静脉组,两组患者的总有效率有明显差异,且有统计学差异(P<0.05)。5静脉化疗疗效与肿瘤淋巴结转移及肿瘤直径有关,与临床分期、组织分化均无关;动脉灌注化疗总的有效率高达93%,但其疗效与临床分期、组织分化、淋巴结转移及肿瘤大小均无明显关系。结论:动脉灌注栓塞化疗在宫颈癌近期治疗效果好,可以有效抑制肿瘤淋巴管生成及血管内皮生长因子的表达。
Objective: To investigate the effects of two neoadjuvant chemotherapy (NACT) on the expression of lymphatic vessel density and vascular endothelial growth factor in cervical cancer. Methods: Sixty patients with stage Ⅰ 2b-Ⅱb cervical squamous cell carcinoma were randomly divided into two groups. They were treated with systemic intravenous chemotherapy and internal iliac artery embolization and chemotherapy. Immunohistochemistry and real-time quantitative polymerase chain reaction The expression of microvessel density (LMVD) and vascular endothelial growth factor-A, C, D (VEGF-A, C and D) in local cervical cancer tissues were analyzed and the relationship between the two NACT efficacy and clinicopathological factors was analyzed. Results: The expression of VEGF, C and D in cancer tissues was significantly higher than that in normal tissues. 2 After intravenous chemotherapy, the expression of VEGF-D in cervical cancer tissues was lower than that before treatment (P <0.05), while the expression of VEGF-A and C had no significant changes before and after treatment. After the arterial infusion chemotherapy, The expression of VEGF-C and D in cancer tissue was significantly lower than that before treatment (P <0.05). The expression of VEGF-A also decreased after treatment, but there was no statistical significance (P> 0.05). Intravenous chemotherapy and intra-arterial infusion chemotherapy all reduced the LMVD in cervical cancer tissues, and the extent of arterial infusion chemotherapy was more significant (P <0.05). Significant clinical remission was achieved in both groups. The efficacy of arterial infusion chemotherapy group was superior to that of intravenous group. There was significant difference between the two groups in total effective rate (P <0.05). The curative effect of IV chemotherapy was related to tumor lymph node metastasis and tumor diameter, but not to clinical staging and tissue differentiation. The total effective rate of arterial infusion chemotherapy was as high as 93%, but its curative effect and clinical stage, histological differentiation, lymph node metastasis and tumor size had no Obvious relationship. Conclusion: Arterial infusion chemotherapy in the treatment of cervical cancer in recent good effect, can effectively inhibit tumor lymphangiogenesis and vascular endothelial growth factor expression.