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目的:探讨新辅助化疗对ⅠB2～ⅡB期宫颈癌的近期疗效。方法:对哈尔滨医科大学附属第二医院2005年9月～2007年1月间ⅠB2～ⅡB期宫颈癌82例进行前瞻性研究,其中42例在根治性手术前行新辅助化疗(Neoadjuvant Chemotherapy,NACT)2～3个疗程,为NACT组,40例在术前未行新辅助化疗,为直接手术组。评价NACT组化疗疗效及影响疗效的相关因素,比较两组手术后的病理结果。结果:NACT的总有效率为76.2%,化疗效果与临床分期和分化程度无关(P>0.05),与病理类型及肿瘤的大小有关,鳞癌的有效率明显高于非磷癌(P<0.05),肿瘤直径>8cm的疗效明显低于≤8cm(P<0.05)。两组术后盆腔淋巴结阳性率及宫旁侵润率之间的差异有统计学意义(P<0.05);在NACT组中化疗有效组与无效组术后盆腔淋巴结阳性率及宫旁侵润率之间的差异有统计学意义(P<0.05)结论:新辅助化疗可改善宫颈癌的临床分期,提高宫颈癌的手术疗效,成为治疗ⅠB2～ⅡB期宫颈癌一种新手段,有较大的临床应用价值
Objective: To investigate the effect of neoadjuvant chemotherapy on stage ⅠB2 ~ ⅡB cervical cancer. Methods: A total of 82 patients with stage ⅠB2 ~ ⅡB cervical cancer from September 2005 to January 2007 in the Second Affiliated Hospital of Harbin Medical University were prospectively studied. Among them, 42 cases underwent radical neoadjuvant chemotherapy (NACT) ) 2 to 3 courses of treatment, NACT group, 40 cases did not receive neoadjuvant chemotherapy before surgery, direct surgery group. Evaluate the curative effect of NACT group and related factors that affect curative effect, and compare the pathological results of the two groups after operation. Results: The total effective rate of NACT was 76.2%. The effect of chemotherapy was not related to the clinical stage and differentiation (P> 0.05), but was related to the pathological type and the size of tumor. The effective rate of squamous cell carcinoma was significantly higher than that of non - ), The effect of tumor diameter> 8cm was significantly lower than ≤ 8cm (P <0.05). There were significant differences between the two groups in the positive rate of pelvic lymph node and the rate of parametrial invasion (P <0.05). In the NACT group, the positive rate of pelvic lymph node and the rate of parametrial invasion (P0.05) .Conclusion: Neoadjuvant chemotherapy can improve the clinical staging of cervical cancer and improve the curative effect of cervical cancer, which has become a new method for treatment of cervical cancer ⅠB2 ~ ⅡB, with a larger Clinical application value