新辅助化疗对早期巨块型宫颈癌作用的临床分析

被引：12

作者：

关明飞

黄鹤

刘继红

机构：

[1] 中山大学肿瘤防治中心妇科

来源：

中国妇产科临床杂志 | 2008年 / 03期

关键词：

宫颈癌; 新辅助化疗; 影响因素;

D O I：

暂无

中图分类号：

R737.33 [子宫肿瘤];

学科分类号：

100214 ;

摘要：

目的探讨新辅助化疗对早期巨块型宫颈癌的疗效及相关影响因素。方法对2005年1月至2006年12月中山大学肿瘤防治中心收治的140例ⅠbⅡa期巨块型宫颈癌患者进行回顾性分析,根据术前是否行新辅助化疗（Neoadjuvant Chemotherapy,NACT）分为两组:NACT组69例,在根治性手术前行1～3个疗程的新辅助化疗;直接手术组71例,术前未接受辅助治疗,直接行根治性手术。术前评价NACT的疗效,并比较两组术中出血量、术后病理特征及并发症。结果NACT总有效率达87.0%;化疗2～3个疗程较1个疗程的有效率高（89.2%和68.1%,P<0.05）;NACT组与直接手术组术后标本病理检查脉管浸润率分别为4.35%和14.08%（P<0.05）,但两组宫颈肿瘤的深肌层浸润（53.62%和67.61%）、淋巴结转移（26.09%和29.58%）、宫旁浸润（2.90%和1.41%）及术后放疗率（63.77%和74.65%）差异均无显著性（P>0.05）;两组手术时间及术后并发症亦无差异（P>0.05）,但NACT组较直接手术组术中出血多,术中输血比例高（46.38%和15.49%,P<0.05）;治疗前鳞状细胞癌抗原（SCC-Ag）≥3.0ng/ml者对NACT的反应率（100%）高于SCC-Ag<3.0ng/ml者（82.5%,P<0.05）。术前Hb水平、临床分期、肿瘤直径、肿瘤大体类型、病理组织学类型、肿瘤分化程度与NACT的反应率无关。结论术前新辅助化疗对早期巨块型宫颈癌有较好的近期疗效,NACT可能减少肿瘤的脉管浸润。治疗前SCC-Ag水平可能有助于预测NACT的近期疗效。

引用

页码：170 / 173+202 +202

页数：5

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