紫杉醇联合铂类新辅助化疗局部晚期宫颈癌效果及对Smac Survivin MMP-2表达的影响

doi:10.3969/j.issn.1006-6233.2018.03.009

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摘要 目的: 探究紫杉醇联合铂类新辅助化疗(NACT)在局部晚期宫颈癌(LACC)治疗中的临床效果及对线粒体促凋亡蛋白(Smac)、凋亡抑制基因(Survivin)、基质金属蛋白酶-2(MMP-2)表达的影响。方法: 用随机数字表法将76例LACC患者分为研究组和对照组各38例。研究组患者予以紫杉醇+顺铂化疗,对照组患者予以顺铂+5-氟尿嘧啶(5-FU)化疗。比较两组患者近期疗效、手术指标、术后淋巴结转移情况和宫颈癌组织中Smac表达情况差异,观察治疗前后血清Survivin、MMP-2水平变化情况,记录毒副反应发生率。结果: 研究组患者有效率高于对照组,手术时间短于对照组,术中出血量少于对照组,术后淋巴结转移率、宫颈癌组织中Smac阳性率均低于对照组(P﹤0.05)。化疗2个疗程后,两组患者血清Survivin、MMP-2水平均较治疗前降低,且研究组低于对照组(P﹤0.05)。两组患者毒副反应发生率比较无显著差异(P﹥0.05)。结论: 紫杉醇联合铂类NACT对LACC有较强疗效,能减少手术出血量、缩短手术时间,降低机体内Smac、Survivin、MMP-2表达,抑制肿瘤转移,有利于病情转归。但应警惕毒副反应发生。

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	张志安
	易红艳

关键词 ：紫杉醇, LACC, NACT, Smac, MMP-2

Abstract：Objective: To explore the clinical effect of paclitaxel combined with platinum neoadjuvant chemotherapy (NACT) in the treatment of locally advanced cervical cancer (LACC) and the influence on the expression of second mitochondria-derived activator of caspase (Smac), apoptosis inhibiting gene (Survivin) and matrix metalloproteinase -2 (MMP-2). Methods: 76 patients with LACC were divided into the study group and the control group by random number table method, 38 cases in each group. Patients in the study group were treated with paclitaxel + cisplatin chemotherapy, while patients in the control group were treated with cisplatin +5- fluorouracil (5-FU) chemotherapy. The short-term curative effect, operation indexes, postoperative lymph node metastasis and the expression of Smac in cervical cancer tissues were compared between the two groups. Changes of serum levels of Survivin and MMP-2 levels before and after treatment were observed, and the incidence of toxic and side reactions was recorded. Results: The response rate of the study group was higher than that of the control group. The operation time, intraoperative blood loss, postoperative lymph node metastasis rate and the positive rate of Smac in the cervical cancer tissues in the study group were shorter / less / lower than those in the control group (P < 0.05). After 2 courses of chemotherapy, serum levels of Survivin and MMP-2 in the two groups were decreased, and the levels in study group were lower than those in the control group (P < 0.05). There was no significant difference in the incidence of toxic and side effects between the two groups (P > 0.05). Conclusion: Paclitaxel combined with platinum NACT is markedly effective in the treatment of LACC. The regimen can reduce the blood loss, shorten the operation time, reduce the expression of Smac, Survivin and MMP-2 and inhibit tumor metastasis. It is conducive to the prognosis of the disease but attention should be paid to toxic and side effects.

Key words： Paclitaxel LACC NACT Smac MMP-2

基金资助:湖北省卫生厅科研项目,(编号:1509327)

引用本文:

张志安, 易红艳. 紫杉醇联合铂类新辅助化疗局部晚期宫颈癌效果及对Smac Survivin MMP-2表达的影响[J]. 河北医学, 2018, 24(3): 385-389.
ZHANG Zhian, YI Hongyan. Effect of Paclitaxel Combined with Platinum Neoadjuvant Chemotherapy on Locally Advanced Cervical Cancer and the Influence on the Expression of Smac Survivin and MMP-2. HeBei Med, 2018, 24(3): 385-389.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.03.009 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I3/385