术前新辅助化疗对宫颈癌细胞超微结构动态改变的观察

发布时间：2018-04-27 20:06

本文选题：宫颈肿瘤 + 新辅助化疗　；参考：《解放军医药杂志》2016年12期

【摘要】：目的探讨术前新辅助化疗(NACT)对宫颈癌细胞超微结构变化的影响。方法将2013年1月—2015年1月经临床确诊的宫颈鳞状细胞癌患者67例作为研究对象,根据治疗方法分为对照组32例和观察组35例,对照组直接行手术治疗,观察组先行NACT治疗,末次化疗结束后2~3周再行手术治疗。评估NACT近期疗效,NACT前后采用CT测量病灶直径,采集病理组织了解线粒体、粗面内质网数量,记录两组手术时间、术中出血量、淋巴结清扫数量、术后并发症发生率、盆腔淋巴结阳性率、宫颈深肌层浸润率及切缘阳性率;随访1年,记录无瘤生存率、总生存率。结果两组手术时间、淋巴结清扫数量、术后并发症发生率、宫颈深肌层浸润率、切缘阳性率、1年无瘤生存率和总生存率比较无差异(P0.05)。观察组NACT化疗近期总有效率71.43%;观察组化疗后肿瘤直径、线粒体数量、粗面内质网数量明显小于化疗前及对照组(P0.05);观察组术中出血量少于对照组(P0.05);观察组盆腔淋巴结阳性率低于对照组(P0.05)。结论术前NACT治疗可缩小肿瘤直径,改善超微结构,降低盆腔淋巴结阳性率。
[Abstract]:Objective to investigate the effect of neoadjuvant chemotherapy before operation on the ultrastructure of cervical cancer cells. Methods Sixty-seven patients with cervical squamous cell carcinoma from January 2013 to January 2015 were divided into control group (n = 32) and observation group (n = 35). The control group was treated directly with NACT. Surgical treatment was performed 2 weeks after the end of the last chemotherapy. Before and after NACT, CT was used to measure the diameter of lesions, to collect pathological tissues to understand the number of mitochondria and rough endoplasmic reticulum, to record the time of operation, the amount of intraoperative bleeding, the number of lymph nodes dissection, and the incidence of postoperative complications. The positive rate of pelvic lymph node invasion of deep layer of cervix and the positive rate of incisal margin were recorded and the tumor-free survival rate and overall survival rate were recorded after 1 year follow up. Results there was no difference in the operation time, the number of lymph nodes dissection, the incidence of postoperative complications, the infiltration rate of deep layer of cervix, the positive rate of incision margin, the 1-year tumor-free survival rate and the overall survival rate. The total effective rate of NACT chemotherapy in the observation group was 71.43 and the diameter of tumor and the number of mitochondria in the observation group after chemotherapy. The amount of rough endoplasmic reticulum was significantly lower than that before chemotherapy and control group (P 0.05), the amount of intraoperative bleeding in the observation group was less than that in the control group (P 0.05), and the positive rate of pelvic lymph nodes in the observation group was lower than that in the control group (P 0.05). Conclusion preoperative NACT therapy can reduce tumor diameter, improve ultrastructure and decrease the positive rate of pelvic lymph nodes.
【作者单位】：达州市中心医院妇产科;
【基金】：四川省卫生厅科研课题(150055)
【分类号】：R737.33

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