| Background and Objective: Neoadjuvant chemotherapy (NACT) for stage I b bulky tumor and locally advanced cervical cancer can decrease clinical stage and improve the effectiveness of the surgery. Neoadjuvant chemotherapy is usually carried out by intravenous or intra-arterial methods. COX-2 is the necessary enzyme for the synthesis of prostaglandins. In resent studies, the high expression of COX-2 has been showed in tumor. Moreover, increased COX-2 expression is associated with chemotherapy response. Ki67 is a remarkable proliferation marker. It has been applied in study on tumors. Nowadays several researches find that it is associated with chemotherapy sensitivity. The purpose of the study is to investigate the expression of cyclooxygenase 2 and Ki67 in cervical carcinoma with neoadjuvant chemotherapy.Methods: There were 40 patients with cervical cancer FIGO stage â… b to â…¢b treated with NACT. The expression of COX-2 and Ki67 were checked bymeans of immunohistochemistry. The relationship between the expression of COX-2 , KJ67 protein and the NACT effect as well as the relationship between the expression of COX-2 , Ki67 protein and clinicopathological factors such as FIGO stage > histotype .Results: (1) After intravenous NACT, 12.5 % of patients (5/40) with complete remission and 29 patients (72.5%) with partial remission were recorded, and the total clinical response ratio of NACT was 85%, compared with 15% of patients with stable disease. (2) The expression value of COX-2 and Ki67 after intravenous NACT (15.57+1.13,15.41+0.74) decreased significantly with those before NACT (21.29+1.22,19.19 + 0.81), p<0.05. (3)Ih complete remission cases to NACT, the expression of COX-2 after NACT (9.77 + 0.74) were significantly decreased than that of the pretreatment cases (20.96+2.43), /K0.05; In partial remission cases to NACT, the expression of COX-2 after NACT (15.10+1.16) were significantly decreased than that of the pretreatment cases (21.66+1.25), /><0.05;A little decrease was found in stable disease cases to NACT but without significance, p>0.05. (4) In complete remission cases to NACT, the expression of Ki67 after NACT (16.25 + 1.77) were significantly decreased than that of the pretreatment cases (22.82 + 2.72), p<0.05; In partial remission cases to NACT, the expression of Ki67 after NACT (15.36 + 0.96) were significantly decreased than that of the pretreatment cases (19.22 + 0.92), /?<0.05;A little decrease was found in stable disease cases to NACT but without significance, /?>0.05.(5)No significance was found in the COX-2 and Ki67 dispersion before and after NACT between different FIGO stages and different grades, p>0.05.(5) But in the squamous cell carcinoma, the dispersion in COX-2 and Ki67 level before and afterNACT was significantly different with those in adenocarcinoma, p<0.05. (6) There was no significant relationship between the expression of COX-2 and Ki67 in those patients before NACT, r=-0.041, p>0.05. Conclusion: (1) The expression of COX-2 and Ki67 were deceased significantly in the cervical cancer after NACT. (2) A significant correlation to the expression of COX-2 and Ki67 with the chemotherapy response to NACT was observed. (3) No significance was found in the COX-2 and Ki67 dispersion before and after NACT between differentiated FIGO stages and differentiated grades. (5) The dispersion in COX-2 and Ki67 level before and after NACT was significantly different in the squamous cell carcinoma with those in adenocarcinoma, which suggest that perhaps the response to NACT in the squamous cell carcinoma is more effective than that in adenocarcinoma. (6) There was no significant relationship between the expression of COX-2 and Ki67 protein Therefore, COX-2 and Ki67 maybe act as new objective markers to evaluate the effect of NACT. |
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