目的:探讨紫杉醇联合顺铂(TP)新辅助化疗与腹腔镜手术联用治疗局部晚期宫颈癌的疗效及对患者分子标志物及免疫功能的影响。方法:选取我院局部晚期宫颈癌患者92例,并依据入院序号分为对照组(n=46)和治疗组(n=46),对照组给予5-氟尿嘧啶+顺铂(PF)新辅助化疗联合腹腔镜宫颈癌根治术,治疗组给予TP新辅助化疗联合腹腔镜宫颈癌根治术。统计并比较两组患者临床疗效；检测并比较两组患者分子标志物水平及免疫功能变化；观察并比较两组患者不良反应发生情况。结果:化疗后,治疗组CR为39.13%,PR为41.30%,NC为13.04%,PD为6.52%,总有效率为80.43%,对照组分别为21.74%、26.09%、30.43%、21.74%,总有效率为47.83%,治疗组总有效率明显高于对照组(P<0.05)；两组不良反应发生率无明显差异(P>0.05)。术后2周两组CEA、SCC-Ag、CYFRA21-1及CA125水平均较治疗前明显下降(P<0.05或P<0.01),且治疗组显著低于对照组(P<0.05或P<0.01)；术后2周两组MMP-2、TIMP-2、VEGF-C和VEGF-D水平均较治疗前明显降低(P<0.01),且治疗组显著低于对照组(P<0.01)；术后2周两组CD3⁺、CD4⁺、CD8⁺比例均较治疗前显著降低,CD4⁺/CD8⁺比值明显升高(P<0.01),但两组间无显著性差异(P>0.05)。结论:对局部晚期宫颈癌患者给予TP新辅助化疗联合腹腔镜手术治疗,可明显提高患者的临床疗效,降低体内分子标志物,并能有效提高患者的免疫功能,且不良反应少,效果确切,安全可靠。

Objective: To investigate the paclitaxel plus cisplatin (TP) neoadjuvant chemotherapy combined with laparoscopic surgery in the treatment of locally advanced cervical cancer and molecular markers on the patients and the efficacy of immune function. Methods: Selected from 92 patients with locally advanced cervical cancer,and on the basis of admission number is divided into the control group (n=46) and treatment group (n=46),the control group given 5 - fluorouracil plus cisplatin (PF),neoadjuvant chemotherapy combined laparoscopic cervical cancer radical new adjuvant chemotherapy combined laparoscopic treatment group given TP cervical cancer radical prostatectomy. The clinical efficacy of the two groups was compared and compared. To detect and compare the level of molecular markers and the changes in immune function in two groups of patients; The adverse reactions occurred in two groups. Results:After chemotherapy,the treatment group 39.13% CR,PR is 41.30%,13.04%,NC PD was 6.52%,total effective rate was 80.43%,the control group were 21.74%,26.09%,30.43%,26.09%,the total effective rate was 47.83%,total effective treatment group was obviously higher than that of control group (P<0.05); There was no significant difference in the incidence of adverse reactions (P>0.05). The levels of CEA,scc-ag,cyfra21-1 and CA125 were significantly lower in 2 weeks after surgery (P<0.05 or P<0.01),and the treatment group was significantly lower than the control group (P<0.05 or P<0.01). Both the mp-2,timp-2,vegf-c and vegf-d levels were significantly lower (P<0.01),and the treatment group was significantly lower than the control group (P<0.01). Both CD3⁺,CD4⁺,and CD8⁺ were significantly reduced in 2 weeks after operation,and the CD4⁺ / CD8⁺ ratio was significantly higher (P<0.01),but no significant difference between the two groups (P>0.05). Conclusion:To give TP neoadjuvant chemotherapy in patients with locally advanced cervical cancer combined laparoscopic surgery,can obviously improve the patient's clinical curative effect,reduce the molecular markers in the body,and can effectively improve the patient's immune function,and less adverse reaction,the effect is exact,safe and reliable.

R737.33

2016年保定市科学技术研究与发现指导计划项目(16ZF103)