本文選題：宮頸癌　切入點(diǎn)：新輔助化療　出處：《中華腫瘤防治雜志》2017年13期

【摘要】：目的宮頸癌新輔助化療(neoadjuvant chemotherapy,NACT)的療效一直存在爭(zhēng)議,PI3K/AKT通路在腫瘤細(xì)胞增殖、遷移、侵襲及抗凋亡都起到舉足輕重的作用。本研究探討NACT對(duì)宮頸鱗狀細(xì)胞癌AKT通路中AKT及P-AKT的表達(dá)對(duì)腫瘤微淋巴管生成的影響,并分析其變化與NACT臨床療效的關(guān)系。方法采用免疫組化SP法分別檢測(cè)2011-03-01-2016-03-31濱州醫(yī)學(xué)院附屬醫(yī)院收治的47例ⅠB2~ⅡB期宮頸鱗癌患者行NACT前后AKT和P-AKT的表達(dá)情況及腫瘤微淋巴管密度(lymphatic microvessel density,LMVD)的變化。結(jié)果免疫組化檢測(cè)結(jié)果顯示,NACT前AK和P-AKT的陽性率分別為93.6%和72.3%,化療后陽性率分別為44.7%和36.2%,NACT前后比較,AKT和P-AKT表達(dá)差異有統(tǒng)計(jì)學(xué)意義,P0.001�；熐皩m頸鱗癌組織中LMVD計(jì)數(shù)為20.87±3.31,化療后宮頸鱗癌組織中LMVD計(jì)數(shù)為16.47±3.44,化療后宮頸鱗癌組織中LMVD明顯降低,t=6.32,P0.001�；熐皩m頸鱗癌AKT陽性的LMVD為21.14±3.19,高于陰性組(17.00±3.00)。Spearman相關(guān)分析顯示,化療前后LMVD的表達(dá)(r_s=0.39,P=0.007)與化療前后P-AKT的表達(dá)(r_s=0.66,P0.001)均呈正相關(guān)�；熀驦MVD與化療后AKT的表達(dá)呈正相關(guān),r_s=0.58,P0.001。淋巴結(jié)轉(zhuǎn)移與化療前后LMVD均呈正相關(guān)(r_s=0.44,P0.001;r_s=0.36,P=0.013)。淋巴結(jié)轉(zhuǎn)移的患者化療前化療后LMVD均高于淋巴結(jié)未轉(zhuǎn)移者。結(jié)論化療前P-AKT的表達(dá)及化療后AKT和P-AKT的表達(dá)與腫瘤微淋巴管生成呈正相關(guān),LMVD與淋巴結(jié)的轉(zhuǎn)移呈正相關(guān),化療前P-AKT的表達(dá)有可能作為預(yù)測(cè)宮頸癌新輔助化療療效的指標(biāo)。
[Abstract]:The purpose of neoadjuvant chemotherapy for cervical cancer (neoadjuvant, chemotherapy, NACT) the curative effect has been controversial, the PI3K/AKT pathway in tumor cell migration, proliferation, invasion and apoptosis have played a pivotal role. This study was to investigate the expression of NACT on AKT and P-AKT in cervical squamous cell carcinoma in AKT pathway on tumor lymphangiogenesis effect to analyze the relationship between NACT changes and clinical curative effect. Methods: SP immunohistochemical method was used to detect 2011-03-01-2016-03-31 in Affiliated Hospital of Binzhou Medical College were 47 cases of B2~ stage B cervical squamous cell carcinoma before and after NACT in patients with AKT and P-AKT expression and tumor lymphatic microvessel density (lymphatic microvessel, density, LMVD) changes. Results the results of immunohistochemistry the results showed that the positive rate of NACT AK and P-AKT were 93.6% and 72.3% after chemotherapy, the positive rates were 44.7% and 36.2%, NACT compared AKT and P-AKT table There are statistically significant differences of P0.001., LMVD before chemotherapy in cervical squamous cell carcinoma count was 20.87 + 3.31, 16.47 + 3.44 in the count of LMVD cervical squamous cell carcinoma LMVD cervical squamous cell carcinoma after chemotherapy, chemotherapy harem was significantly lower, t=6.32, P0.001. before chemotherapy of cervical squamous cell carcinoma with AKT positive LMVD was 21.14 + 3.19, higher than the negative group (17 + 3).Spearman correlation analysis showed that the expression of LMVD before and after chemotherapy (r_s=0.39, P=0.007) and the expression of P-AKT before and after chemotherapy (r_s=0.66, P0.001) were positively correlated. After chemotherapy, LMVD and AKT after chemotherapy of r_s= expression was 0.58, lymph node metastasis and chemotherapy before and after P0.001. LMVD were positively correlated (r_s=0.44, P0.001; r_s=0.36, P=0.013). Chemotherapy in patients with lymph node metastasis before LMVD after chemotherapy were higher than those without lymph node metastasis. Conclusion the expression of P-AKT after chemotherapy before chemotherapy and the expression of AKT and P-AKT with tumor lymphangiogenesis was positively related to LM The expression of VD is positively correlated with the metastasis of lymph nodes. The expression of P-AKT before chemotherapy may be an indicator of the efficacy of new adjuvant chemotherapy for cervical cancer.

【作者單位】： 濱州醫(yī)學(xué)院附屬醫(yī)院婦科;
【分類號(hào)】：R737.33

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