新辅助化疗在宫颈癌Ⅱ期的临床运用价值

doi:10.3877/cma.j.issn.1673-5250.2008.05.107

目的

本研究探讨介入化疗方案在宫颈癌Ⅱ期新辅助化疗中的临床价值。

方法

以2004年8月至2008年2月解放军452医院妇产科诊断为宫颈癌Ⅱ期的30例患者为研究对象。其中，14例符合介入治疗纳入标准(介入化疗组)，行超选插管化疗栓塞，2～3周后，根据疗效，行宫颈癌子宫广泛切除术＋盆腔淋巴结清扫术；16例不符合介入治疗标准患者(单纯手术组)行宫颈癌子宫广泛切除术。分析两组手术中出血量、术后病理学报告等临床资料，并评估疗效。

结果

14例行介入治疗患者(介入化疗组)中，13例有效，行子宫广泛切除术＋盆腔淋巴结清扫术；1例无效，行放射治疗。介入化疗组较单纯手术组术中出血量少。介入放疗组病理报告提示，肿瘤坏死、变性，瘤体组织中有炎性细胞浸润，周围脉管系统内未见癌栓形成。

结论

介入栓塞治疗是宫颈癌Ⅱ期新辅助化疗有效的辅助方法。

关键词: 宫颈癌, 化疗栓塞, 新辅助化疗

Objective

To investigate the clinical value of interventional therapy in neoadjuvant chemotherapy on cervical cancer stage Ⅱ.

Methods

30 patients with cervical cancer stage Ⅱ with pathological diagnosis were admitted to the No.452 Hospital Affiliated to PLA, among which 14 cases were administered in superselective catheterization chemoembolization plus radical hysterectomy as the intervention therapy group, the other 16 cases underwent extensive hysterectomy as the mere operation group. Two groups were compared by the blood loss, lesion size and pathology.

Results

In the intervention therapy group, one case was transferred to radiotherapy for lack of significant improvement after chemoembolization, and the remaining 13 cases received radical hysterectomy with pelvic lymphadenectomy. In contrast to the mere operation group, the average blood loss significantly decreased in the intervention therapy group, together with improved pathological characters like tumor necrosis, degeneration, immunocyte invasion and lack of tumor thrombus in periphery vasculature.

Conclusion

Preoperative interventional therapy is an effective method in neoadjuvant chemotherapy of cervical cancer stage Ⅱ.

Key words: cervical cancer, chemoembolization, neoadjuvant chemotherapy

图1　栓塞化疗前右子宫动脉造影

图2　栓塞化疗前左子宫动脉造影

图3　栓塞化疗后左子宫动脉造影

图4　栓塞化疗后腹主动脉造影

图5　介入治疗后渐癌细胞坏死(HE×200)

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Clinical Evaluation of Interventional Therapy in Neoadjuvant Chemotherapy of Cervical Cancer Stage Ⅱ

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Clinical Evaluation of Interventional Therapy in Neoadjuvant Chemotherapy of Cervical Cancer Stage Ⅱ