The Expression And Significance Of Ki-67 And Survivin Before And After Neoadjuvant Chemotherapy In Cervical Carcinoma

[Objective]Through observing and detecting the expression and change of Ki-67 and Survivin before and after neoadjuvant chemotherapy in cervical carcinoma,the purpose of the study is to investigate the expression and change of Ki-67 and Survivin in cervical carcinoma with neoadjuvant sensitivity,curative effect,clinical pathology and so forth.To make neoadjuvant chemotherapy individualization,it can prevent from delaying operation and radiotherapy because of useless and unfine chemotherapy.Looking for a new index to forecast sensitivity and to appraise curative effect of neoadjuvant chemotherapy in cervical carcinoma.[Methods]There are 64 patients with cervical cancer FIGO stageⅠb toⅢb treated with NACT.The expression of Ki-67 and Survivin is checked by immunochemistry S-P method,and analyze the relationship between the expression of Ki-67 protein,Survivin and the NACT effect as well as the relationship between the expression of Ki-67 protein,Survivin and clinic pathological factors such as FIGO stage,histotype and so forth.[Results](1)After NACT,54 patients have gain curative effect,the total clinical response ratio of NACT is 84.38%(54/64),10.94%of patients(7/64)with complete remission and 46 patients 71.9%(47/64)with partial remission is recorded,and compared with 15.62%(10/64)of patients with stable disease.(2)The expression of Ki-67 and Survivin before and after NACT:①Comparing with the exponent of positive cell of Ki-67 before NACT,the exponent of positive cell of Ki-67 after NACT show decreased significantly(P＜0.01).②Comparing with The exponent of positive cell of Survivin before NACT,the exponent of positive cell of Survivin after NACT show decreased significantly too(P＜0.01).(3)The expression and change of Ki-67 and Survivin in different curative effect cases before and after NACT:①In complete remission and partial remission cases,the expression of Ki-67 and Survivin after NACT show decreased significantly(P＜0.01);②In stable disease cases,the expression of Ki-67 and Survivin after NACT has no obvious change(P＞0.05);③The comparison of the change of Ki-67 and Survivin before and after NACT between in complete remission cases and in partial remission cases offer obvious difference.The descend of Ki-67 and Survivin after NACT in complete remission cases offer more obvious than it in partial remission cases.(4)The expression of Ki-67 and Survivin in different curative effect cases before NACT:①In complete remission cases,partial remission cases and stable disease cases,the expression of Ki-67 before NACT show decreased significantly (F=13.99,P＜0.01);②The expression of Ki-67 before NACT in complete remission is more higher than it in partial remission cases(P＜0.01);the expression of Ki-67 before NACT in partial remission cases is more higher than it in stable disease cases(P＜0.01);③The expression of Survivin in different curative effect cases before NACT has no obvious contrast(F=0.002,P＞0.05). The comparison ofinterclass has no obvious discrepancy(P＞0.05).(5)The change of Ki-67 and Survivin in different histology type before and after NACT:In the squamous cell carcinoma,the change of Ki-67 and Survivin level before and after NACT is significantly different with those in adenocarcinoma(P＜0.01).(6)In different FIGO stages(Ⅰb～Ⅲb),no significance is found in the change of Ki-67 and Survivin before and after NACT(P＞0.05).(7)The change of Ki-67 and Survivin(△Ki-67,△Survivin)in different pathology before and after NACT has no obvious contrast(P＞0.05).(8)There is significant direct correlation between the expression of Ki-67 and Survivin in these patients before and after NACT(before NACT:r=0.701,P＜ 0.01;aflerNACT:r=0.767,P＜0.01).[Conclusion]1.The arterial perfusion neoadjuvant chemotherapy is an effective means to cure the cancer of the cervix.2.The change of Ki-67 and Survivin after NACT has obvious dependablity with the curative effect of NACT.The more obviously Ki-67 and Survivin descend after NACT,the better NACT can gain curative effect.3.The expression of Ki-67 before NACT correlate obviously with the curative effect of NACT.The more highly Ki-67 express before NACT,the better NACT can gain curative effect.The expression of Survivin before NACT have no dependablity with the curative effect of NACT.4.The squamous cell carcinoma has higher sensitiveness and better curative effect to NACT than adenocarcinoma.5.The change of Ki-67 and Survivin after NACT has no dependablity with FIGO stages and pathology class.6.There is significant direct correlation between the expression of Ki-67 and Survivin.