吉西他滨结合放、化疗对宫颈癌血管生成及侵袭能力的影响
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篇名: 吉西他滨结合放、化疗对宫颈癌血管生成及侵袭能力的影响
TITLE:
摘要: 目的:探讨吉西他滨结合放、化疗对宫颈癌血管生成及侵袭能力的影响。方法:选取2015年1月-2016年6月重庆市开州区人民医院收治的拟行手术的宫颈癌患者37例,按照随机数字表法分为观察组(n=19)和对照组(n=18)。对照组患者给予三维适形放疗和化疗,化疗方案为顺铂注射液70 mg/m2,ivgtt+氟尿嘧啶注射液600 mg/m2,ivgtt,放疗后第1、21天给药;观察组患者在对照组基础上给予注射用盐酸吉西他滨800 mg/m2,ivgtt,放疗后第1、8天给药。两组患者均以28 d为1个周期,治疗2个周期后行广泛性子宫切除术和盆腔淋巴结清扫术。观察两组患者临床疗效、肿瘤微血管密度(MVD)、血管内皮生长因子(VEGF)、细胞外因子蛋白(Wnt)1、Wnt3a、Wnt8和β-链蛋白(β-catenin)通路水平,分析MVD与VEGF的相关性,并记录不良反应发生情况。结果:观察组患者临床总有效率(84.2%)明显高于对照组(50.0%),差异有统计学意义(P<0.05)。两组患者病灶组织MVD、VEGF、Wnt1、Wnt3a、Wnt8和β-catenin水平均明显高于健康组织,观察组患者病灶组织上述指标水平均明显低于对照组病灶组织,差异均有统计学意义(P<0.05)。MVD与VEGF水平呈正相关性。两组患者不良反应发生率比较,差异无统计学意义(31.6% vs. 27.8%,P>0.05)。结论:吉西他滨结合放、化疗可有效调控宫颈癌细胞血管生成和Wnt/β-catenin信号通路活性,降低宫颈癌细胞的侵袭能力,可能为其发挥抗癌作用的重要机制之一,且安全性较好。
ABSTRACT: OBJECTIVE: To investigate the effects of gemcitabine combined with radiotherapy and chemotherapy on angiogenesis and cell invasion ability of cervical cancer. METHODS: Totally 37 patients undergoing radical operation selected from Chongqing Kaizhou District People’s Hospital during Jan. 2015-Jun. 2016 were divided into observation group (n=19) and control group (n=18). Control group was given 3-D conformal radiation and chemotherapy which included Cisplatin injection 70 mg/m2,ivgtt+Fluorouracil injection 600 mg/m2,ivgtt on 1st and 21st day after radiotherapy.  Observation group was additionally given Gemcitabine hydrochloride for injection 800 mg/m2,ivgtt, 1st and 8th day after radiotherapy. A treatment course lasted for 28 d. The radical hysterectomy and  pelvic lymphadenectomy were conducted after 2 courses of treatment. Clinical efficacy, microvessel density (MVD) of tumor, vascular endothelial growth factor (VEGF), Wnt1, Wnt3a, Wnt8 and β-catenin level were observed in 2 groups. The relationship of MVD with VEGF was analyzed, and the occurrence of ADR was recorded. RESULTS: The total response rate of observation group (84.2%) was significantly higher than control group, with statistical significance (P<0.05). The levels of MVD, VEGF, Wnt1, Wnt3a, Wnt8 and β-catenin in 2 groups were significantly higher than healthy tissue; above indexes of focus tissue in observation group were significantly lower than control group, with statistical significance (P<0.05). MVD was positively correlated with VEGF. There was no statistical significance in the incidence of ADR between 2 groups (31.6% vs. 27.8%, P<0.05). CONCLUSIONS: Gemcitabine combined with radiotherapy and chemotherapy can regulate the angiogenesis of cervical cancer cell and the activity of Wnt/β-catenin signal pathway, and reduce the invasion ability of cervical cancer cell, which may be the important mechanism of anti-tumor effect with good safety.
期刊: 2017年第28卷第11期
作者: 蒋晓蓉,李万平,熊林
AUTHORS: JIANG Xiaorong,LI Wanping,XIONG Lin
关键字: 吉西他滨;宫颈癌;血管内皮生长因子;肿瘤微血管密度;细胞侵袭;Wnt通路
KEYWORDS: Gemcitabine; Cervical cancer; Vascular endothelial growth factor; Microvascular density of tumor; Cell invasion; Wnt pathway
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