The Predict Value Of PCNa And SCCa To The Sensitivity And Effect Of NACT In Patients With Squamous Cell Carcinoma Of The Uterine Cervix

Objective:The purpose of this study was to detect and indentify theexpression of proliferating cell nuclear antigen(PCNA) and Squamous CellCarcinoma antigen(SCCA) in valid and invalid specimens of patients who hadsquamous cell carcinoma of the uterine cervix neoadjuvant chemotherapy,so asto investigate the feasibility of PCNA and SCCA as an sensitive and effectivemaker of neoadjuvant chemotherapy(NACT)in patients with squamous cellcarcinoma of the uterine cervix. Methods:Tissue specimens of56patientswith IB2～IIB squamous cell carcinoma of the uterine cervix who receivedneoadjuvant chemotherapy in the Affiliated Hospital of Guilin MedicalUniversity from April2006to April2012were collected. And collecting theserum of16the aforesaid patients from April2011to April2012. Expression ofPCNA in cervical tissues before and after neoadjuvant chemotherapy were detected by immunohistochemical staining, and SCCA in serum byenzyme-linked immunosorbent assay (ELISA). The clinical therapeutic effectwas evaluated after two or three weeks of neoadjuvant chemotherapy andpatients were than divided into effective group, and non-effective group. Results:1.The clinical curative effect of neoadjuvant chemotherapy：complete remission(CR) in3cases, accounting for5.4%，partial remission (PR) in35cases,accounting for62.5%， the total clinical valid rate (CR+PR) was67.9%(38/56);stable disease (SD) in13cases, accounting for23.2%,progressivedisease(PD) in5cases, accounting for8.9%.The clinical valid rate of PF was67.5%(27/40);the clinical valid rate of TC was68.8%(11/16).The operative rateafter NACT was100%(56/56). The effect of NACT was associated with clinicalstage of （χ2=9.468, P<0.01), has nothing to do with the pathological grade (χ2=0.679, P>0.05).2.Expressions of PCNA of patients who had squamous cellcarcinoma of the uterine cervix neoadjuvant chemotherapy(NACT),before andafter,have great differences (P<0.01).The levels of PCNA in valid groupsignificantly decreased after chemotherapy,which shows statisticalsignificance(P<0.01),The levels of PCNA in invalid group slightly decreased, nosignificant difference (P>0.05).In valid group,expression of PCNA wassignificant higher than that in invalid group before NACT(P<0.01).3.In thisstudy，the positive rate of SCCA who with squamous cell carcinoma of theuterine cervix was68.75%(11/16).Expressions of SCCA of patients who had squamous cell carcinoma of the uterine cervix neoadjuvantchemotherapy(NACT),before and after,have great differences (P<0.01).Thelevels of SCCA in valid group significantly decreased afterchemotherapy,which shows statistical significance(P<0.01),The levels of SCCAin invalid group slightly decreased, no significant difference (P>0.05).In validgroup,expression of SCCA was significant higher than that in invalid groupbefore NACT(P<0.01).the reduction percentage of serum SCCA level in validgroup after first NACT is higher than that in invalid group.4.Both the reductionpercentage of tissue PCNA and serum SCCA after NACT were significantcorrelated with the ratio of the tumor shrinkage,the reduction percentage oftissue PCNA after NACT were positively correlated with the ratio of the tumorshrinkage(P<0.01),the reduction percentage of tissue SCCA after NACT werepositively correlated with the ratio of the tumor shrinkage(P<0.05), the reductionpercentage of tissue PCNA were positively correlated with the reductionpercentage of tissue SCCA(P<0.05). Conclusions:1.PF project and TC projectare valid neoadjuvant chemotherapy projects for squamous cell carcinoma of theuterine cervix, and the effect of neoadjuvant chemotherapy was related to TNMstage, and was not related to pathology grade.2.Expressions of PCNA andSCCA of patients who had squamous cell carcinoma of the uterine cervixneoadjuvant chemotherapy,before and after,have great differences.Which can beused on evaluate the clinical efficacy of neoadjuvant chemotherapy to patients who has squamous cell carcinoma of the uterine cervix.3.If PCNA and SCCAcould help predict the sensitivity response on clinical efficacy of neoadjuvantchemotherapy for squamous cell carcinoma of the uterine cervix is clear.4.Itwould be a valid marker for the sensitivity and effect of NACT in patients withsquamous cell carcinoma of the uterine cervix to cheek both tissue PCNA andserum SCCA.