Research Of Chemotherapy Effect On Cervical Carcinoma Strengthened By Ultrasound Combined With Microbubble

Cervical cancer is the most common female malignant tumor, and It's high incidence rate arouse people's attention. The incidence of the cervical carcinoma in the developing country accouts for 80% of the globe annual incidence. Cervical squamous cell carcinoma take up more than 80%, the proportion of Cervical adenocarcinoma and cervical gland scale cancer also gradually increased. Commonly, Cervical cancer happens to women who are at the middle age of 40 to 70, but the increasingly incidence at a younger age has been found in recent years. The most characterized symptoms are colporrhagia, and Contact bleeding and Irregular bleeding are common. Some women are diagnosised by physical examination. Currently, the causes of cervical cancer are the HPV infection and feculent sexual behavior. According to the tumor staging, the treatment includes surgery, radiotherapy and chemotherapy. And early detection of tumor then take reasonable therapy which can improve the rate of survival. With the improvement of living standards and the increasing number of women who requires to keep the fertility function, the treatment of cervical cancer not only follows the international standardization method but also needs more individualized therapy.A large number of clinical trials found that the neoadjuvant chemotherapy for the locally advanced cervical cancer could significantly increase the tumor remission rate to nearly 48%~100% and 5 years survival rate is about 83%. But the tumor response to chemotherapy drug resistance and the side effects of chemotherapy drugs make chemotherapy application restricted. The previous conclusions by our research team that high pressure ultrasonic causes a majority of the vascular endothelial cell damage, micro thrombosis, and an increase of permeability of blood vessel walls while low pressure ultrasound make tumor blood vessels expand, faster peak blood flow and tumor vessels perfusion increase shows that the cavitation effect by different intensity and frequency of ultrasound can make the contra influences in hemodynamic response within tumor. In order to throw a light upon this phenomenon and clarify the mechanism of the hypothesis, we use the low-frequency ultrasound and microbubble mediated chemotherapy on Hela cell. The proliferation of Hela cells and the proportion of cell apoptosis were measured, the low-frequency ultrasound could enhance the sensitivity of drug on Hela cell with the cell proliferation slowly and increase cell apoptosis to some extent. In order to further confirm with it, 10 cervical cancer underwent neoadjuvant chemotherapy,combine with ultrasound, microbubble and hydrogen peroxide treatment are applied before the surgery. Using the B-mode model and Flash model ultrasound parameters. Then compare the size of cervical tumor before chemotherapy to after it, assess values of the contrast-enhance ultrasound to analyse the changes of tumor's hemodynamic and grade the pathological result of cervical cancer after surgical.METHOD In part I, CCK-8 method was applied to estimate the growth inhibition of Hela cells treated with Cisplatin. The proliferation of each group was examined with CCK-8. The proportion of cell apoptosis in each group was measured with Flow cytometry analysis. Morphology of cell apoptosis was observed by Hoechst33342 fluorescent staining.In part II, 10 cervical cancer patients underwent neoadjuvant chemotherapy, diagnostic ultrasound,microbubble and hydrogen peroxide treatment, by comparing the size of the cervical tumor before and after neoadjuvant chemotherapy in patients, through the study of the ultrasonic imaging of the cervical cancer, and the quantitative analysis of multiple imaging parameters, grade the pathological results after surgical of patient.RESULT 1. The IC50 of Cisplatin acted on the Hela cells was 4.822?g/ml 2. The cytoactive in group PUM and group PU decreased compared with control group. 3. The cell apoptosis of group PUM was higher than that of other groups. 4. The size of the cervical lump in experiment group indicates that the maximum line from 40.90 mm decrease to 11.43 mm. 5. Analysis the parameters of Contrast-Enhanced ultrasound: The PI(peak intensity) and AUC(area under the curve) that were detected has an increase after the ultrasound therapy by B-MODE model and the TP(time to peak) and MTT(mean transition time) that were detected has an increase after the ultrasound therapy by Flash model. 6. The result of Pathologic results show that ultrasound therapy have the trend of increase no cancer rate.CONCLUSION 1. ultrasound with Low-intensity and low-frequency can enhance the sensitivity of Cisplatin on Hela cell, with the cell proliferation inhibited and apoptosis increased. 2. Ultrasound, microbubble and hydrogen peroxide mediated chemotherapy can significantly change the cervical tumor hemodynamic state, and this effect may cause certain sensitive variation of cervical cancer chemotherapy.