中国实用妇科与产科杂志

中国实用妇科与产科杂志

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重组人5型腺病毒在宫颈癌动脉化疗栓塞中的疗效评价

张萍,陈龙,张维娜,张盛苗   

  1. 作者单位：青岛市立医院妇科，山东 青岛266011
  • 出版日期:2015-05-02 发布日期:2015-05-13
  • 通讯作者: 陈龙
  • 基金资助:

    青岛市科技发展计划项目（编号14-2-3-20-nsh）

Clinical value of recombinant human adenovirus type 5 in transarterial chemoembolization in patients with cervical cancer.

ZHANG Ping, CHEN Long, ZHANG Wei-na, ZHANG Sheng-miao.   

  1. Department of Gynecology, Qingdao Municipal Hospital, Qingdao 266011,China
  • Online:2015-05-02 Published:2015-05-13

摘要：

目的 探讨重组人5型腺病毒在宫颈癌动脉灌注化疗栓塞中的疗效。方法 选择2008年6月至2014年12月青岛市立医院收治的经病理证实为ⅠB2～ⅡB期宫颈癌患者92例，随机分为两组，47例为重组人5型腺病毒及奈达铂化疗栓塞组（研究组），45例为奈达铂化疗栓塞组(对照组)。84例患者于3～4周后行手术治疗。比较两组动脉化疗栓塞后病灶缩小情况，鳞状细胞癌抗原（SCC-Ag）、高危人乳头瘤病毒（HR-HPV）水平变化，手术情况，术后病理及不良反应。结果 动脉灌注化疗栓塞前后研究组与对照组病灶缩小有效率分别为89.36％和84.44％，差异无统计学意义（χ2=0.49，P=0.484）；SCC-Ag下降率分别为78.72％和64.44％，差异无统计学意义（χ2=2.31，P=0.128），HR-HPV下降率分别为57.45％和28.89％，差异有统计学意义（χ2=7.63，P=0.006）；术中出血量（t=3.57,P<0.001）、脉管瘤栓(χ2=7.11,P=0.008)明显减少，而淋巴结阳性(χ2=0.70,P=0.404)、神经侵袭(χ2=1.74,P=0.188)及宫旁浸润率(χ2=1.30,P=0.254)，差异无统计学意义；两组动脉化疗栓塞后高热的发生率差异具有统计学意义（χ2=9.21，P=0.002）。结论 重组人5型腺病毒用于宫颈癌动脉灌注化疗栓塞，可一定程度上利于后续手术操作，增强疗效，且无明显不良反应，是宫颈癌治疗研究领域中一个值得提倡的方法。

关键词: 宫颈癌, 动脉化疗栓塞, 重组人5型腺病毒

Abstract:

Abstract： Objective To evaluate the clinical value of recombinant human adenovirus type 5 in transarterial chemoembolization in patients with cervical cancer. Methods A total of 92 patients with cervical cancer (ⅠB2-ⅡB) from June 2008 to December 2014 were divided into two groups. Experimental group (47 patients) received recombinant human adenovirus type 5 and transarterial chemoembolization，while the control group (45 patients) received transarterial chemoembolization only.Totally 84 cases received operation therapy after 3-4 weeks. The tumor size, levels of SCC-Ag and HR-HPV，operation situation, postoperative pathology and toxicity of the two groups were compared respectively. Results  Compared with control group（84.44％）, the tumor regression rate of the experimental group(89.36％) had no significant difference（χ2=0.49,P=0.484）;there was no significant difference (χ2=2.31,P=0.128) between experimental group(78.72％) and control group(64.44％) in terms of the decreased level of SCC-Ag;the expression level decrease of HR-HPV in experimental group(57.45％) was significantly more than that of the control group(28.89％) (χ2=7.63，P=0.006).  Blood lose（t=3.57,P<0.001）and vascular tumors bolt(χ2=7.11,P=0.008) decreased significantly, but the total positive rate of lymph nodes(χ2=0.70,P=0.404), parametrium invasion (χ2=1.74,P=0.188) and parametrial infiltration (χ2=1.30,P=0.254) had no significant difference between the two groups. The incidence of the high fever had significant difference（χ2=9.21，P=0.002）. Conclusions   In the treatment of transarterial chemoembolization for the cervical cancer, recombinant human adenovirus type 5 can be beneficial to the operation and reinforce the treatment effect, and do not increase the adverse reaction rate. It is a treatment method worthy of being explored in the research field of  cervical cancer.

Key words: cervical cancer, transarterial chemoembolization, recombinant human adenovirus type 5

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