Ralation Between Expression Of Fas/FasL And Sensitivity Of Concomitant Chemoradiation In Locally Advanced Cervical Cancer

Background & ObjectiveInvasive cervical cancer is the most frequent gynecological cancer.In the more gynecological cancer,incidence of it is the second.Invasive cervical cancer is the leading cause of gynecological cancer death in China.Disease incidence is 9.98/100,000,and the mortality is 3.25/100,000.Concomitant chemoradiation(CCR)becoming more and more important in therapy of cervical cancer,but the sensitivity and effect for different individual was different.We hope through detecting the value of Fas/Fasl on the prognosis inâ… b2-â…¡b locally advanced cervical cancer(LACC)to make it clear that the meaning of individual therapy in cervical cancer.MethodsA retrospective study was carried out on 35 patients withâ… b2-â…¡b locally advanced cervical cancers adimitted to our hospital from 2001-2003.ALL patients received pre-operation CCR,then radical operation of uterine cervix cancer.To evaluate the effect and divide into two groups:no remain tumor group(CR)and remain tumor group (PR+SD+PD).To detecting the expression of the Fas/Fasl in two groups by immunohistochemical method and clinical and pathological significance of differentially expression were analysized.Results35 patients finished CCR and received radical operation of uterine cervix cancer,surgery achievement ratio was 100%.The postoperation pathological exam showed the patients with no remain tumor was 16 cases(CR group),remain tumor 19cases(14 cases in PR group,5 cases in SD and PD group);pathological complete remission ratio was 45.71%(16/35);effective group 30 cases(16 cases in CR group and 14 cases in PR group),effective ratio 85.71%,ineffective patients were 5 cases,ineffective ratio 14.28%(5/35).The 3-year survival rate of all cases was 87.14%,The 3-year survival rate of remain tumor was 76.32%,that was significantly decreased compared with 100%of patients with no remain tumor.For tumor tissue of locally advanced cervical cancer,the expression rate of Fas in remain tumor group was significantly decreased compared with 100%of no remain tumor group (P=0.013).the expression rate of Fasl in remain tumor group was no significantly decreased compared with no remain tumor group(P= 0.293).the expression rate of Fas/Fasl in the remain tumor group(19 cases)post-operation was significantly increased compared with pro-CCR(P_fas=0.013,P_fas1=0.029).The Fas expression rate of cases with vessel tumor embolus was significantly decreased compared with none(P=0.006);the expression Fasl in moderately and poorly differentiated tomor was significantly increased compared with well differentiated tumor(P=0.037);the expression Fasl in cases with vessel tumor embolus tomor was significantly decreased compared with none (P=0.035).ConclusionWe can expect satisfactory results by pre-operation CCR treated LACC in intermediate stage,it is benefical in followed therapy after surgery.The status of remain tumor plays a important role in prognosis. Probabily,the changes of Fas/Fas1 is one of factors that make worse prognosis in advanced cervical cancer and low sensitivity of CCR and make a new way for individual therapy.