Clinical Experiment On TP Program Leading To Ovarian Injury Of Cervical Cancer Patients With Neoadjuvant Chemotherapy

Objective:To research the ovarian tissues of patients with cervical cancer or other reproductive system tumors, study cisplatin and paclitaxel (TP) program on cervical cancer after neoadjuvant chemotherapy in patients with ovarian effects, and drugs such as cisplatin lead to ovarian damage mechanism. To provide a theoretical basis for further prevention and treatment of ovarian damage of chemotherapy.Materials and methods:Select the seventy-one patients(average age 42.01土3.19 years old) with cervical cancer after neoadjuvant chemotherapy or carcinoma of endometrium in the First Affiliated Hospital of Jinan University from September 2007 to October 2009. Collect the part of ovarian tissue after Surgical resection. The patients with cervical cancer after neoadjuvant chemotherapy are treated by cisplatin and paclitaxel program (TP1) or cisplatin and docetaxel program(TP2). Seventy-one patients were divided into experimental group (51 cases) and control group (20 cases), the experimental group was divided into TP1 group (23 cases) and TP2 group (28 cases). Some ovarian tissue will be collected by the formalin-fixed, paraffin section and HE staining to do histological examination, detect expression of inhibitor of apoptosis (Bcl-2) and apoptotic factor (Bax) by immunohistochemistry of human ovarian tissue. Apoptosis of granulosa cells in ovarian tissue is assayed with the TUNEL. use ELISA and CLIA to detect the cervical cancer patients'serum before and after chemotherapy in 51 cases of inhibin B, estradiol and follicle stimulating hormone (INHB, E2 and FSH) levels.Results:1. Conventional paraffin, HE staining was observed, the experimental group appeared ovarian tissue fibrosis, vascular abundant, very few follicles.2.The expression of Bcl-2 in ovarian tissue between experimental group and control group were significantly different, but the expression of Bax was no significant difference.3.Ovarian granulosa cell apoptosis showed a significant difference between experimental group and control group, the control group was lower than the experimental group.4. there was no significant difference of basic E2, LH and FSH concentrations, INHB level in the two groups (P values>0.05). After three courses of chemotherapy, INHB, E2 concentrations were lower than in the chemotherapy group(P values<0.05), while FSH,LH concentrations higher than those without chemotherapy (P values＜0.05).Conclusions:Patients are subject to ovarian damage with cisplatin and paclitaxel, or cisplatin and docetaxel in neoadjuvant chemotherapy in the treatment of cervical cancer, experiments show that human ovarian tissue damage caused by cisplatin and other chemotherapeutic drugs may be related to granule cells and Oocyte apoptosis.