Neoadjuvant Chemotherapy For Locally Advanced Cervical Cancer And Its Sensitivity Related Gene Expression

Background and ObjectiveCervical cancer is one of the most common gynecologic malignant tumors,the incidence of the disease is the first in our country about the female genital malignant tumors,due to the popularity of the cancer screening,early detection and treatment of the cervical cancer 5 years survival rate increased gradually,in recent years,we found that the incidence of cervical cancer has showed the trend of younger,so the treatment of cervical cancer and the burden of diseases still can not be underestimated.Since Frei first proposed the Neoadjuvant Chemotherapy in 1982,the treatment mode of cervical cancer has been transformed into neoadjuvant chemotherapy combined with surgery,radiotherapy and chemotherapy or targeted therapy.The clinical data showed that neoadjuvant chemotherapy can help narrow the cervical carcinoma,increase operation rate,reduce the recurrence,suggesting that early is not sensitive to chemotherapy,but because of the same drug administration route and dosage,side effects,resulting in cost,patient acceptance,administration way there is still a huge controversy.And when the effect of neoadjuvant chemotherapy is not good,it will no longer delay the treatment of cervical cancer,resulting in unnecessary side effects and economic burden.Therefore,we hope that we can have more comprehensive and reliable indicators to predict the efficacy of neoadjuvant chemotherapy.Therefore,the aim of this study is to investigate the short-term clinical effects of neoadjuvant chemotherapy with different routes of administration on locally advanced cervical cancer,analyze the relationship between VEGFR2 and the occurrence and development of cervical cancer,and the significance of the expression before and after neoadjuvant chemotherapy in cervical cancer,and the feasibility of the effect prediction.Methods1.the clinical data of 110 cases of Ⅰb2 to Ⅱb cervical cancer from January 2011 to December 2016 in Zhujiang hospital were retrospectively analyzed.(1)according to whether neoadjuvant chemotherapy was applied,43 cases were divided into chemotherapy group and 45 cases in direct operation group.The short-term curative effect of neoadjuvant chemotherapy was analyzed,and the postoperative pathological risk factors,operation time and the amount of bleeding during the operation were compared between the two groups.(2)according to neoadjuvant chemotherapy,there were 22 cases of venous group and 21 cases of interventional group.After NACT,the pathological risk factors,operative time and intraoperative blood loss were not evaluated in two groups.2.collect 74cases of cervical biopsy or hysterectomy in gynecologic clinic of a hospital inZhujiang in January 2016-12.Paraffin fixed and immunohistochemical analysis were used to analyze the expression of VEGFR2 in different pathological cervix tissues.3.18 cases were completely diagnosed,and the cervical specimens of patients with locally advanced cervical cancer were treated with neoadjuvant chemotherapy.Immunohistochemistry was performed to analyze the expression of VEGFR2 before and after neoadjuvant chemotherapy.Statistical MethodsSPSS 20 software was used for statistical processing.The counting data were checked by chi square test,t test was used for measurement data,rank data was used for rank sum test,and the P value<0.05 was considered to have statistical difference.ResultsNeoadjuvant chemotherapy for cervical cancer can make the tumor shrink,increase the chance of operation,reduce the postoperative pathologic risk factors,but no significant improvement in the operating time and intraoperative blood loss;the effective rate of neoadjuvant chemotherapy and the age of patients,irrespective of the route of administration,related to the clinical stage of cervical cancer and the pathological types of cervical cancer had no significant difference;neoadjuvant chemotherapy embolization chemotherapy and intravenous chemotherapy two treatment,the efficacy and toxicity of chemotherapy;the expression of VEGFR2 in cervical tissue cell membrane and cytoplasm,according to the different expression in different cervical lesions,from high to low is cervical cancer,CIN,chronic cervicitis,VEGFR2 expression and age cervical cancer,staging,pathological type,differentiation degree and CIN stage,the expression of VEGFR2 and cervical cancer neoadjuvant chemotherapy,patients with VEGFR2 effective chemotherapy were low expression.ConclusionsNeoadjuvant chemotherapy for cervical cancer can reduce the tumor,improve the postoperative pathologic risk factors;neoadjuvant chemotherapy is better for squamous cell carcinoma and cervical cancer in stage IIA and stage above;neoadjuvant chemotherapy to different pathologic risk factors and postoperative administration and operation of cervical cancer in effect no difference;the expression of VEGFR2 and cervical tissue involvement of expression from high to low cervical cancer>CIN>chronic cervicitis;the expression of VEGFR2 with age,clinical staging,CIN staging,differentiation,pathological malignancy was negatively correlated;the expression of VEGFR2 and cervical cancer neoadjuvant chemotherapy,chemotherapy effective neoadjuvant chemotherapy patients after VEGFR2 were low.However whether it is possible to be a sensitive index for predicting platinum class chemotherapeutic drugs in cervical cancer and whether it is related to the early lymph node metastasis is still to be studied.