| Objective:Investigate the relationship between the expression of DNA-PKcs,Ku70 and the chemoradiotherapy sensitivity in middle-late cervical carcinoma,the expression of changes in cancer tissue after chemoradiotherapy. Looking for a index to predict the sensitivity of cervical cancer.Observe term effect of artery NACT+CCR in middle-late cervical carcinoma. Explore a new model that increase the effect in middle-late cervical carcinoma.Methods:60 patients that vary fromⅡb toⅢb cervical cancer were collected. The patients were randomly divided into A, B, C three treatment groups,20 patients in each.Group A used the method of chemotherapy combined with radiotherapy simultaneous.Group B used the method of neoadjuvant chemotherapy and radiotherapy.Group C used the method of neoadjuvant chemotherapy and chemotherapy combined with radiotherapy simultaneous.Adapted the method of immunohistochemistry to detect the expression of DNA-PKcs and Ku70 in 42 cases that medium-term advanced cervical cancer biopsy specimens before treatment and the third week of starting treatment. Analysis the correlation between the expression of them and chemoradiotherapy sensitivity, study the relationship between expression changes after chemoradiotherapy and term effect.Results: 1.The expression of DNA-PKcs in high-chemoradiotherapy sensitivity grope was significantly lower than that of low-chemoradiotherapy sensitive group. Chemotherapy sensitivity was negative correlation with expression of DNA-PKcs(Z =-5.583 P=0.000<0.01, r=-0.513). Combine DNA-PKcs and Ku70 detection, which the expression of different sensitivity groups were incomplete the same, there were highly significant difference(P=0.000<0.01) 16.7% in both positive grope were highly sensitive (1/16).100% in both negative were highly sensitive (3/3) Comparison between groups showed that both positive group,the one positive group and both negative group,the chemoradiotherapy sensitivity were significantly different.(P respectively were 0.048,0.040).The comparison between the both positive group and the one positive group were not significantly different(P= 0.655>0.05).2.Comparison with the expression of DNA-PKcs positive cells before treatment, the expression of DNA-PKcs positive cells after treatment decreased significantly(Z=-4.567, P= 0.000< 0.01).The expression of DNA-PKcs,46.2% in group A decreased (6/13),35.7% in group B decreased (5/14),86.7% in group C decreased (13/15).Decline rate of group C was higher than group A and group B(Z=-4.567, P= 0.00< 0.05). Comparison between groups showed the decline rate of DNA-PKcs,group A and group B were not significantly different. Group C,compared with group A,group B,was statisticly different(group A vs group B,χ~2=0.304, P= 0.581; group A vs group C,χ~2=5.440, P=0.02; group B vs group C,χ~2=7.985, P =0.005).The half time of partial tumor regression,group A was 37.080 days,group B was 39.643 days,group C was 28.000 days.The differences were statically different(F = 81.62, P=0.000<0.01).Further comparison(q test) between groups showed P values were all less than 0.05.Time spent of group C was shorter than group A and group B.Half time of partial tumor regression,group B is the longest.Group A is between group B and group C. Pearson correlation analysis showed the degree of decreased expression of DNA-PKcs after treatment had negative correlation with the time of half tumor regression. correlation coefficient was-0.924.The more obviously the expression decreased,the shorter the time of half tumor regression. 3. Correlation analysis showed that the expression of DNA-PKcs was no correlation with the expression of Ku70(Correctionχ~2=0.000, P= 1.000>0.05)).4. Term effect:Complete remission rate of local tumor of group A,group B and group C were respectively 65%,75%,90%(χ~2=3.798, P=0.15>0.05).The differences were pointless.pelvis local region control rate of group A was 20%,group B was 10%,group C was 80%(χ~2=24.689,P=0.000<0.01).There were highly significant differences.Neoadjuvant chemotherapy combine with concurrent chemotherapy group was compared with the other two group, remission rate was significantly increased parametrial. There were highly significant differences(group A vs group C:χ~2=14.4, P=0.00; group B vs group C:χ~2=19.798, P=0.000). there was no highly significant differences between grope A and group B (χ~2=0.196, P=0.658>0.05).5.Toxicity:the incidence of grade 3 hematogenous side effect in three groups,group A was 35%,group B was 5%,group C was 40%(χ~2=7033, P=0.026<0.05). There were significant differences. Comparison between groups showed that incidence of severe hematogenous side effect,group B is lower than other two groups(group A vs group B:χ~2=3.906, P=0.048<0.05; group B vs group C:χ~2=5.161, P=0.023< 0.05).Group A vs group C (χ~2=0.107, P=0.144>0.05), there were no significant differences.In three groups,the incidence of severe gastrointestinal reactions was no highly significant differences (χ~2=0.313, P=0.855>0.05)Conclusions:1.Expression of DNA-PKcs before therapy have negative correlation with chemoradiotherapy sensitivity in middle-late phase cervical carcinoma. DNA-Pkcs may become the index of predicting chemoradiotherapy sensitivity of middle-late phase cervical carcinoma.Co-detection of DNA-PKcs and Ku70 before therapy is helpful to the prediction of the chemoradiotherapy sensitivity in middle-late phase cervical carcinoma.Both positive ones were low sensitivity.2. The expression of DNA-PKcs in middle-late phase cervical carcinoma after therapy decreased obviously compared with that before therapy,whith was negative correlation with the time of half tumor regression.This illustrate that with the decreased expression of DNA-PKcs,chemoradiotherapy sensitivity increased.3. In the therapy of artery intervention NACT+CCR, local tumor of middle-late phase cervical carcinoma subside quickly and improve term effect obviously,compared with CCR, without increasing toxicity.This is a safe and effective mode for middle-late phase cervical carcinoma therapy,it can increase radiotherapy effection and have clinical value. |
PDF Full Text Request