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目的分析评价吉西他滨增敏对局部晚期宫颈癌放疗微血管密度及凋亡的影响。方法将47例中晚期宫颈癌患者(ⅡB期,Ⅲ期,ⅣA期)随机分成两组:A组22例为放疗+吉西他滨(商品名:健择)组;B组25例,行单纯放疗。每个病例在放疗前及放疗10Gy后的24小时各取材一次。免疫组化S-P法测定微血管密度(MVD),TUNEL法检测癌组织凋亡标记指数(A-LI),计算肿瘤消退50％所需时间(T0．5)。结果①A组MVD表达降低的程度(16．00根／mm2)明显高于B组(2．00根／mm2),P=0．001;②A组诱导A-LI增加(0．57％)明显高于B组(0．24％),P=0．034;③A组T0．5(9．0d)显著短于B组(15．0d),P=0．018;④A组MVD表达降低与T0．5呈明显负相关(r=-0．628);⑤A组胃肠道与血液系统不良反应与B组比较无差异。结论吉西他滨增敏使宫颈癌放疗早期血管生成减少,凋亡增加,局部肿瘤体积缩小的速度加快,而不良反应并不增加。
Objective To evaluate the effect of gemcitabine sensitization on microvascular density and apoptosis in locally advanced cervical cancer. Methods Forty - seven patients with advanced cervical cancer (stage ⅡB, Ⅲ, ⅣA) were randomly divided into two groups: 22 cases in group A were treated with radiotherapy plus gemcitabine (brand name: Gemzar); 25 cases in group B received radiotherapy alone. Each case before radiotherapy and radiotherapy 10Gy 24 hours after each drawing. The microvessel density (MVD) was measured by immunohistochemical S-P method. Apoptosis index (A-LI) was detected by TUNEL method and the time required for tumor regression by 50% (T0.5) was calculated. Results ① The decrease of MVD expression in group A (16.00 root / mm2) was significantly higher than that in group B (2.00 / mm2), P = 0.001; ② The increase of A-LI induced by group A (0.57%) was obvious (P <0.01); (3) Compared with group B (0.24%), P = 0.034; ③T0.5 (9.0d) in group A was significantly shorter than that in group B T0.5 showed a significant negative correlation (r = -0.628); ⑤A group of gastrointestinal and hematological adverse reactions compared with the B group no difference. Conclusion Gemcitabine sensitizes cervical cancer to reduce angiogenesis and apoptosis in the early stage of radiotherapy. The local tumor volume shrinks faster but the adverse reaction does not increase.