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目的:探讨增殖细胞核抗原(PCNA)及鳞状细胞癌抗原(SCCA)作为评价宫颈鳞癌新辅助化疗(NACT)敏感性及疗效指标的可行性。方法:收集2006年4月～2012年4月桂林医学院附属医院56例IB2～IIB期宫颈鳞癌NACT前后组织标本及其中的2011年4月～2012年4月16例宫颈鳞癌NACT前后血清标本,采用免疫组化法测定癌组织中PCNA的表达,ELISA检测血清中SCCA的表达。结果:56例宫颈鳞癌经NACT治疗2～3周后评价临床疗效,临床总有效率为67.9%(38/56)。有效组NACT前组织PCNA指数及血清SCCA水平均高于无效组(P<0.01),有效组PCNA指数及血清SCCA水平化疗后明显下降(P<0.01)。NACT后组织PCNA降幅和血清SCCA降幅与肿瘤缩小比例之间有显著相关性(r=0.808,P<0.01;r=0.708,P<0.05)。结论:联合检测组织增殖细胞核抗原及血清鳞状细胞癌抗原可作为评价宫颈鳞癌新辅助化疗敏感性和疗效的有效指标之一。
Objective: To investigate the feasibility of detecting proliferating cell nuclear antigen (PCNA) and squamous cell carcinoma antigen (SCCA) as a sensitive and effective index for evaluating neoadjuvant chemotherapy (NACT) in cervical squamous cell carcinoma. Methods: From April 2006 to April 2012, 56 patients with cervical squamous cell carcinoma of stage IB2-IIB NACT before and after cervical cancer were collected from April 2006 to April 2012 in our hospital from April 2011 to April 2012, The expression of PCNA in cancer tissue was detected by immunohistochemistry and the expression of SCCA in serum was detected by ELISA. Results: The clinical efficacy of 56 cases of cervical squamous cell carcinoma treated with NACT for 2 to 3 weeks was evaluated. The total clinical effective rate was 67.9% (38/56). The PCNA index and serum SCCA level in the pre-NACT group were significantly higher than those in the ineffective group (P <0.01). The effective PCNA index and serum SCCA level were significantly decreased (P <0.01). There was a significant correlation between the decrease of PCNA and the decrease of SCCA after NACT (r = 0.808, P <0.01; r = 0.708, P <0.05). Conclusion: Combined detection of proliferating cell nuclear antigen and serum squamous cell carcinoma antigen can be used as one of the effective indicators to evaluate the sensitivity and efficacy of neoadjuvant chemotherapy for cervical squamous cell carcinoma.