Preliminary Study On The Effect Of The Infusion Intra-arterial Chemotheraphy Before Opration To Lymphatic Metastasis In Cervical Cancer And The Possible Mechanism

Objective:The infusion intra-arterial chemotheraphy for locally advanced cervical cancer has been used in clinic for almost half a centry.The short-term effect is remarkable.On the contrary,the long-term effect is still undefined.Up to now,this method hasn't been brought into FIGO guideline.The reason is worthing searching.First,through a retrospective cohort study,we analysed the ratio of lymphatic metastasis and cancer embolism in patient who was doing the infusion intra-arterial chemotheraphy before opreation,using the operations' as control.Based on the result above,in vitro test,we used cisplatin affecting Hela cell in a short-time and observed the expression of adhesion molecule CD44.From these tests,we hope to get a preliminary conclusion on the long-term effect of the infusion intra-arterial chemotheraphy to cervical cancer.Methods and Materials:1.Collecting the medical records of patients who have the cervical cancerⅠb-Ⅱb during 2001-2007 in Shanghai Red House Hospital,including diagnoses,treatment,pathology after theraphy.Analysing the difference of lymphatic metastaiss and cancer embolism between the operative patients and intra-arterial chemotheraphy ones.2.Using cisplatin to do a MTT at different time point(4.5h,9h,18h,36h,72h) and with different comcerntration(0.005mM,0.05mM,0.5mM,5mM).3.Using the nutrient fluid including cisplatin(0.05mM) to culture cells,at the time point(0hr,4hr,Shr,16hr,24hr,32hr),picking up the mRNA,and then doing the real-time PCR to quantitativly analyse the expression of adhesion molecule CD44 in Hela cells.4.Using the nutrient fluid including cisplatin(0.05mM) to culture cell for 6 hours,and then changing to DMEM,at the time point(0hr,1hr,2hr,4hr,Shr,16hr,32hr),picking up the mRNA and doing the real-time PCR to quantitative analyse the expression of adhesion molecule CD44 in Hela cells.Results:1.The ratio of lymphatic metastasis of the infusion intra-arterial chemotheraphy forⅠB toⅡb locally advanced cervical cancer was higher than the opreations', while the cancer embolism was lower.The result is significantly different between two protocols(P＜0.05).2.The sustaining action of cisplatin can decrease the expressin of CD44 in Hela cells;after the short-time work of cisplatin,the expression of CD44 became higher and more fluctuant than the normal Hela cells without cisplatin,and then the Hela cells,which were cultured by sustaining cisplatin as well.Conclusion:1.The infusion intra-arterial chemotheraphy for locally advanced cervical cancer may increase the risk factor in the metastasis of cervical cancer.2.Afer the short-time work of cisplatin,the expression of CD44 became higer and more fluctuant,which means the short-time work of cisplatin may improve the tumor cells' exfoliation,metastasis,and settlement.It also may be related to the increased ratio of lymphatic metastasis in the infusion intra-arterial chemotheraphy for locally advanced cervical cancer.