论文部分内容阅读
目的:研究PB方案(顺铂DDP、博莱霉素BLM),并了解其对Wee1蛋白表达的影响。方法:1、用PB方案对64例ⅠB~ⅡB期宫颈癌病人进行介入化疗,观察化疗前后宫颈肿瘤体积变化及化疗后反应,评价介入化疗的效果。2、比较介入化疗后手术患者(观察组)与直接手术患者(对照组)术中情况及术后病理情况,评价介入化疗的近期疗效。3、测定介入前后Wee1表达的变化,及与临床病理的关系,了解PB方案对Wee1的影响。结果:PB方案介入化疗的有效率(CR+PR)为87.5%,缓解率为96.9%,34.4%出现了发热反应,未见其他明显不良反应。试验组和对照组手术时间分别为(2.92±0.3)h和(3.28±0.55)h,术中出血量分别为(453.1±131.9)mL和(542.8±5.6)mL,两组在手术时间和术中出血量方面差异有统计学意义(P<0.05),两组术后在盆腔淋巴结转移、脉管浸润、宫旁浸润及阴道切缘受累方面差异均有统计学意义(P<0.05)。PB方案介入化疗后,Wee1的表达较介入化疗前显著降低,差异有统计学意义(P<0.05),和临床分期、病理类型、淋巴结转移及病理分级无关,差异无统计学意义(P>0.05)。结论:PB介入化疗方案有效、低毒,对ⅠB~ⅡB期宫颈癌治疗具有较好的疗效,PB方案是值得推广的介入化疗方案,Wee1蛋白有望成为监测PB方案介入化疗疗效的指标。
OBJECTIVE: To study the PB regimen (cisplatin DDP, bleomycin BLM) and its effect on Wee1 protein expression. Sixty-four patients with stageⅠB-ⅡB cervical cancer were treated with PB chemotherapy. The changes of cervical tumor volume before and after chemotherapy and the response after chemotherapy were observed, and the effect of interventional chemotherapy was evaluated. To compare the intraoperative status and the postoperative pathology of patients undergoing surgery (observation group) and direct surgery patients (control group), evaluate the short-term curative effect of interventional chemotherapy. To determine the change of Wee1 expression before and after intervention and its relationship with clinicopathology, to understand the influence of PB program on Wee1. Results: The response rate (CR + PR) of PB regimen was 87.5%, the remission rate was 96.9%, and 34.4% had fever reaction. No other obvious adverse reactions were found. The operative time in trial group and control group were (2.92 ± 0.3) h and (3.28 ± 0.55) h respectively, and the amount of bleeding during operation were (453.1 ± 131.9) mL and (542.8 ± 5.6) mL respectively. (P <0.05). There were significant differences in pelvic lymph node metastasis, vascular invasion, uterine infiltration and vaginal margin involvement between the two groups (P <0.05). After intervention of chemotherapy with PB, the expression of Wee1 was significantly lower than that before intervention (P <0.05), and had no relationship with clinical stage, pathological type, lymph node metastasis and pathological grade (P> 0.05 ). Conclusion: PB intervention chemotherapy is effective and has low toxicity. It has a good curative effect on the treatment of stage ⅠB ~ ⅡB cervical cancer. The PB regimen is worthy of promotion of interventional chemotherapy. Wee1 protein is expected to be an indicator to monitor the efficacy of PB regimen in chemotherapy.