本文選題：宮頸腫瘤 + 新輔助化療　； 參考：《解放軍醫(yī)藥雜志》2016年12期

【摘要】：目的探討術(shù)前新輔助化療(NACT)對宮頸癌細胞超微結(jié)構(gòu)變化的影響。方法將2013年1月—2015年1月經(jīng)臨床確診的宮頸鱗狀細胞癌患者67例作為研究對象,根據(jù)治療方法分為對照組32例和觀察組35例,對照組直接行手術(shù)治療,觀察組先行NACT治療,末次化療結(jié)束后2~3周再行手術(shù)治療。評估NACT近期療效,NACT前后采用CT測量病灶直徑,采集病理組織了解線粒體、粗面內(nèi)質(zhì)網(wǎng)數(shù)量,記錄兩組手術(shù)時間、術(shù)中出血量、淋巴結(jié)清掃數(shù)量、術(shù)后并發(fā)癥發(fā)生率、盆腔淋巴結(jié)陽性率、宮頸深肌層浸潤率及切緣陽性率;隨訪1年,記錄無瘤生存率、總生存率。結(jié)果兩組手術(shù)時間、淋巴結(jié)清掃數(shù)量、術(shù)后并發(fā)癥發(fā)生率、宮頸深肌層浸潤率、切緣陽性率、1年無瘤生存率和總生存率比較無差異(P0.05)。觀察組NACT化療近期總有效率71.43%;觀察組化療后腫瘤直徑、線粒體數(shù)量、粗面內(nèi)質(zhì)網(wǎng)數(shù)量明顯小于化療前及對照組(P0.05);觀察組術(shù)中出血量少于對照組(P0.05);觀察組盆腔淋巴結(jié)陽性率低于對照組(P0.05)。結(jié)論術(shù)前NACT治療可縮小腫瘤直徑,改善超微結(jié)構(gòu),降低盆腔淋巴結(jié)陽性率。
[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.
【作者單位】： 達州市中心醫(yī)院婦產(chǎn)科;
【基金】：四川省衛(wèi)生廳科研課題(150055)
【分類號】：R737.33

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