Correlation Study Of ATP-TCA,Expression Of Drug Resistance Genes And Short-term Efficacy Of Neoadjuvant Chemotherapy On Cervical Cancer In Stage ?b2-?b

[Purpose] To evaluate the relationship between ATP-TCA detection and short-term therapeutic efficacy of neoadjuvant chemotherapy on cervical cancer in stage ?b2-?b.To evaluate the relationship between the expression of drug resistance genes and short-term efficacy.To improve the predictive power of clinical chemotherapy for cervical cancer in stage ?b2-?b individual treatment,which combined ATP-TCA tumor chemosensitivity with expression of drug resistance genes.[Methods] 100 cases of cervical squamous cancer in stage ?b2-?b were collected before treatment.Viable cervical cancer cells obtained from malignant tissue were tested for their in vitro sensitivity to PTX,CBP and PTX+CBP using ATP-TCA method.At the same time,EnVision immunohistochemistry was used to analyze P-gp,GST-?,Topo ? and TS relative expression in 95 tumor specimens.The patients were treated with PTX+CBP after sampling immediately,with systemic administration of intravenous medications.They received two courses of chemotherapy and the interval between the two courses was 3 weeks.Short-term efficacy of neoadjuvant chemotherapy was observed 2-3 weeks after treatment.Both methods' clinical relevance of chemosensitivity and the correlation between these two methods were statistically analyzed.The feasibility of the combined application of these two methods for predicting the sensitivity of clinical chemotherapy was evaluated,too.[Results](1)95 cases of cervical cancer were included in the final study.5 cases achived CR after neoadjuvant chemotherapy,68 cases achived PR,21 cases achived SD and 1 cases achived PD.The effective rate(CR+PR)was 76.84%(73/95).(2)The evaluable ATP-TCA assay rate was 95%.The effective rate in vitro assay was 80%.Correlation analysis between the result of ATP-TCA and the short-term efficacy was performed.In vitro result of ATP-TCA was significant related with short-term efficacy(P<0.05)and the predictive rate was 86.32%.PTX+CBP regime predictive sensitivity,predictive specificity,positive predictive value and negative predictive value was 93.15%,63.64%,89.47% and 73.68% respectively.(3)The positive expression of drug resistance protein P-gp,GST-?,Topo ?and TS were 40 cases(42.11%),27 cases(28.42%),32 cases(33.68%)and 53 cases(55.79%)respectively.Correlation analysis between the results of method of EnVision immunohistochemistry assay and the short-term efficacy was performed.The expression of P-gp,GST-?,Topo ? in cervical squamous cancer was associated with the short-term efficacy.The predictive rate of the expression of GST-? is 75.79%,which is the highest among these three protein.Its predictive sensitivity,predictive specificity,positive predictive value and negative predictive value were 80.82%,59.09%,86.76% and 48.15% respectively.(4)The correlation between the result of ATP-TCA and the positive expression of drug resistance protein was compared.The result of ATP-TCA was associated with drug resistance protein GST-? only(P<0.05).The coincidence rate between detection of drug resistance genes with ATP-TCA is 81.05%.(5)ATP-TCA result combined with expression of drug resistance protein when these two indicators all showed resistance defined as resistence.The expression of drug resistance protein GST-?,Topo ? and TS with ATP-TCA was significant related with short-term efficacy(P<0.05).ATP-TCA combined with drug resistance protein GST-? have the best coincidence rate up to 87.37%.[Conclusion] In vitro result of ATP-TCA was significant related with short-term efficacy,and the predictive rate was 86.32%.The expression of P-gp,GST-?,Topo ? in cervical squamous cancer was associated with the short-term efficacy.The predictive rate of the expression of GST-? is 75.79%,which is the highest among these three protein.The expression of drug resistance protein GST-?,Topo ? and TS with ATP-TCA was significant related with short-term efficacy.ATP-TCA combined with drug resistance protein GST-? have the best coincidence rate up to 87.37%.ATP-TCA and expression of drug resistance genes may be used as a method of in vitro drug sensitivity test.Combined the expression of drug resistance genes GST-? with ATP-TCA result,the coincidence rate with the short-term efficacy of the joint methods was higher than that of ATP-TCA or expression of drug resistance genes alone.Combination of ATP-TCA method and expression of drug resistance protein GST-? may be able to effectively predict clinical chemotherapy sensitivity,providing the basis for further effective clinical research.