| Ojective: To observe to curative effect of different approaches of neoadjuvant chemotherapy and impacting on the expression of MMP-2 in locally advanced cervical cancer, to study the relationship among the clinical pathologic factors and efficacy of neoadjuvant chemotherapy,the expression of MMP – 2.Methods: Were retrospectively analyzed cervical cancer cases and pathologic data from the south China affiliated hospital of nanhua university 、 the second affiliated hospital of south China university 、changde city first people’s hospital of obstetrics and gynecology between January 2010 and January 2015, These cervical cancer cases and pathological data must be by pathological diagnosis,and subject to NACT and radical surgery,and complete clinical pathological data and tumor diameter ≧ 4 cm inⅠB ~ⅡB period(in 2009 the international union of gynecology and obstetrics(FIGO) staging criteria).According to different chemotherapy way was divided into: group A: by the artery interventional embolization neoadjuvant chemotherapy plus radical surgery(IACT + RS)and group B: transvenous neoadjuvant chemotherapy plus radical surgery(IVCT + RS), group C: direct surgical group(RS) as control group. The combination with chemotherapy drugs on the basis of the platinum,surgery way were all choosen extensive hysterectomy + pelvic lymph node cleaning surgery(radical surgery), its necessary by abdominal aorta lymph node sampling,resection specimens sent disease inspection after the operation. To observe the general clinical data and comparative analysis of recent curative effect and side effects of chemotherapy in three groups of cervical cancer neoadjuvant chemotherapy, to observe the operation time, intraoperative blood loss, intraoperative complications and postoperative pathologic lymph node metastasis. And to observe the new adjuvant chemotherapy in the near future curative effect and the relationship between clinical pathological factors.At the same time with rabbit against people polyclonal antibody, immunohistochemical SP method detected to expression level of MMP-2 in pre-and postoperative pathological paraffin specimens of three groups cervical cancer.Analysis relationship of MMP-2 with the clinicopathological factors of cervical cancer.Results: 1. After different ways of neoadjuvant chemotherapy(Group A and group B),through inspection of cervical cancer tumor diameter,and found most of them obviously narrow down, group A compared with group C(P < 0.05), group B compared with group C(P <0.05), the three compared groups had significant difference, Group A compared with group B(P > 0.05), showing no obvious significant differences, no statistical significance.The recent efficacy of neoadjuvant chemotherapy associated with the clinical stage of cervical cancer(P <0.05), it had nothing to do with the pathological type,organization cell differentiation degree of cervical cancer(P > 0.05).2. there was small side effects of different ways of neoadjuvant chemotherapy,no significant difference(P > 0.05), average surgery time of three groups of patients with cervical cancer: group A(IACT + RS group) : 236.43±71.34(min),group B(IVCT + RS group) : 301.45±63.72(min), group C group(RS) : 235.64± 51.97(min).Group A compared with group C(P> 0.05),the comparison of group B and group C(P< 0.05), group A and group B(P< 0.05), showing the group A could obviously shorten the operation time.average surgery intraoperative blood loss of three groups of cervical cancer: group A: 541±377(ml), group B:558 ±394(ml), group C: 603±190(ml); group A compared with group C(P = 0.448), group B compared with group C(P = 0.592), group A compared with group B(P = 0.891),all P> 0.05, to show that there was no significant difference.The postoperative pathological section inspection of three group cases of cervical cancer shows: the postoperative lymph node metastasis rate of group A was 30.4%(7/23),the postoperative lymph node metastasis rate of group B was 15%(3/20),the lymph node metastasis rate of group C was 3.6%(1/27).Group A compared with group B(P> 0.05);Group B compared with group C(P >0.05), showing no obvious significant differences, no statistical significance.group A compared with group C(P< 0.05), showing there was significant difference.3. There was high expression degree of positive rate of MMP-2 in cervical cancer tissue.The high expression degree of positive rate of MMP-2 before chemotherapy(before the operation) among comparison of three groups cervical cancer(P <0.05), the difference was statistically significant, showing high expression degree of positive rate of MMP-2 of group A and group B was significantly higher than group C before chemotherapy(before the operation),there was no significant difference in high expression degree of positive rate of MMP-2 between group A and group B.High expression of MMP- 2 were associated with cervical cancer clinical stage(P < 0.05), has nothing to do with the pathological type, histological grade(P > 0.05). MMP- 2 high expression positive rate of group A was 78.3% after chemotherapy(after the surgery), group B was 80%, group C was 82.1%, the three compared(P> 0.942), After chemotherapy(after the surgery) group A compared with group B(P>0.05), there was no significant difference, no statistical significance.4. MMP-2 expression degree study of Three groups of cervical cancer before and after treatment: the high expression degree of positiverate of MMP-2 of group A before and after chemotherapy was P < 0.05,showing there was significant difference.MMP- 2 expression degree reduced of group A after chemotherapy had not shown association with clinical stage, histological grade, and lymph node metastases(P>0.05). To compare high expression degree of positive rate of MMP- 2 of group B and group C before and after treatment(P > 0.05), there was no significant difference, no statistical significance.Conclutions: 1. The arterial and venous neoadjuvant chemotherapy had recent curative effect obviously for locally advanced cervical cancer,having nothing to do with the way of chemotherapy.The recent efficacy of neoadjuvant chemotherapy is associated with the clinical stage of cervical cancer.2. The MMP-2 positive expression in cervical cancer.The high expression degree of positive rate of MMP-2 in cervical cancer is associated with cervical cancer clinical stage.the artery neoadjuvant chemotherapy can reduce high expression degree of positive rate of MMP- 2. |
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