A Preliminary Study Of The Laparoscopic Radical Hysterectomy’s Impact On Cervical Cancer Micrometastases

Objective:To explore the influence of laparoscopic radical hysterectomy on the peripheral blood micrometastases,meanwhile disscuss the relationship between the cytokeratin (CK) 19 mRNA, CK20 mRNA and squmaous cell carcinoma antigen (SCC-Ag) mRNA with clinical pathological parameters.Materials and methods:78 cases of Ib1 stage cervical cancer patients collected as the experimental group,divided into laparoscopy group and laparotomy group according to the operation method,2 groups of patients were 30 cases and 48 cases respectively.34 cases of uterine fibroids patients as the positive control group,32 healthy subjects as the negative control group, who were all treated by the Department of Gynecologic Oncology in Third Affiliated Hospital of Kunming Medical University during October 2010-September 2013. Real-time Fluorescence Quantitative reverse transcription polymerase chain reaction (RT-FQ-PCR) was used to amplify peripheral blood CK19, CK20 and SCC gene from total RNA, to measure and compare the preoperative expression levels in the experimental group, positive control group and negative control group. The CK19, CK20 and SCCAg expression levels before cervical cancer radical hysterectomy,24 hours and 30 days after surgery were measured and compared. Meanwhile, the changes of CK19, CK20 and SCCAg expression levels measured above were compared between the laparoscopic group and laparotomy group. Analyzed the relationship between these genes and clinicopathological features simultaneously.Results:1.The CK19, CK20 and SCCAg expression levels in the experimental group befor surgery were (0.0035±0.0018), (1.06±0.49) and (1.48±0.46), respectively, and the positive rates were 32.1%(25/78),33.3%(26/78) and 35.9%(28/78), respectively. The CK19, CK20 and SCCAg expression levels in the experimental group befor surgery were significantly higher than those in the positive and negative control group, and there were no significant differences between the positive and negative control group.2.There were no significant differences in CK19, CK20 and SCCAg mRNA expression levels before surgery,24 hours and 30 days after surgery between laparoscopic group and laparotomy group (P> 0.05).3.The expression levels and positive rates of CK19, CK20 and SCCAg mRNA before cervical cancer radical prostatectomy were significantly lower than those the time of 24 hours (P< 0.05) and 30 days (P> 0.05) after surgery.4.The positive expression rate of single gene in the experimental group before surgery had no correlation with the age and the tumor diameter(P>0.05).It had correlation with difference level and vessel carcinoma embolus(P<0.05), and high correlation with myometrial invasion and pelvic lymph nodes metastasis (P<0.01).Conclusions:1. Both laparotomy and laparoscopic cervical cancer radical prostatectomy can increase the circulating tumor cell in peripheral blood, but there is no significant difference in circulating tumor cell expression level between two groups.2. The expression levels of CK19, CK20 and SCCAg mRNA before cervical cancer radical prostatectomy were significantly lower than those at 24 hours and 30 days after surgery.This might due to the homing of tumor stem cells.3. Detect molecular maker(CK19、CK20、SCC-Ag mRNA) by using Q-PCR might be the auxiliary indexes to monitor recurrences and (or) metastases, and judge prognoses.