The Expression Of Mtdh And Bcl-2 In Cervical Cancer And Their Relationship With Radiosensitivity

OBJECTIVE:By detecting the expression of bcl-2 and mtdh in cervical squamous cell carcinoma,the clinicopathological characteristics of the expression of Bcl-2 and mtdh in cervical squamous cell carcinoma and the correlation between the expressions were preliminarily analyzed.And,the relationship between the expression of bcl-2 and mtdh and the radiotherapy effect(radiosensitivity)of cervical squamous cell carcinoma was also preliminarily discussed.Clinical data and methods:65 cases of cervical squamous cell carcinoma diagnosed in our hospital between June 2015 and January 2020 were collected.The age range: 26-73 years old,the average age is 52 years old,38 of them ? 50 years old,27 of them < 50 years old;clinical stage(FIGO 2009 version): 44 cases in early stage(I-IIa1 stage),21 cases in middle and late stage(IIa2,IIB-IV stage);treatment plan: 44 cases of surgical patients,21 cases of synchronous radiotherapy and chemotherapy patients;tumor diameter: 27 cases were ? 4cm,38 cases were < 4cm,18 cases had lymph node metastasis,47 cases had no lymph node metastasis.All patients were confirmed by pathology,and no neoadjuvant radiotherapy,chemotherapy and embolization were performed before the diagnosis.According to the recist1.1 standard,the patients in the concurrent radiotherapy and chemotherapy group were examined with Pelvic MRI 4 weeks after treatment,and the curative effect was evaluated according to the results of imaging examination.CR was regarded as the radiotherapy sensitive group,PD + PR + SD as the radiotherapy resistant group.The expression level of bcl-2 and mtdh was determined by immunohistochemistry.The expression of bcl-2 and mtdh in cervical squamous cell carcinoma was analyzed.The expression characteristics of bcl-2 and mtdh in early operation group,middle and late stage concurrent radiotherapy and chemotherapy group and the correlation between the expression of bcl-2 and mtdh were analyzed.At the same time,the relationship between the expression of bcl-2 and mtdh and the radiosensitivity of cervical squamous cell carcinoma was preliminarily discussed based on MRI images before and after treatment and referring to the recist1.1 standard.Counting data used chi-square test,FISHER exact probability method,paired samples applied paired sample t test or rank sum test,and correlation analysis applied spearman rank correlation analysis.Experimental results:1.Immunohistochemical detection of all 65 patients with pathological specimens before treatment: 1.1 bcl-2 expression in this sample was 33/65(50.8%)positive,mtdh expression was 47/65(72.3%).There is a positive correlation between mtdh and bcl-2.(r=0.422,p <0.05);1.2 bcl-2 expression is correlated with lymph node metastasis,and the difference is statistically significant(?2= 14.473,p <0.05)And there was no statistical significance between age,disease stage and tumor size;1.3 mtdh expression was also related to lymph node metastasis(?2= 4.659,p <0.05),but not related to age,tumor size and disease stage.2.The positive rates of bcl-2 and mtdh in early surgery patients were 22/44(50%)and 29/44(65.9%)respectively,and there was a positive correlation between the two(r = 0.527,p <0.05).;bcl-2 expression is closely related to tumor stage,degree of differentiation,depth of invasion and lymph node metastasis,and the difference is statistically significant(its chi-square value and p-value are: ?2 = 4.956,?2= 4.697,?2= 6.086,?2 = 7.486,p <0.05);the positive expression of mtdh is correlated with the degree of tumor differentiation,the depth of infiltration,lymphatic vessels and nerve invasion,and the differences are statistically significant(the chi-square value and the values are: ?2= 4.381,?2 = 21.465,?2 = 8.193,?2 = 3.373,p <0.05).3.The positive expression rates of bcl-2 and mtdh in patients with concurrent chemoradiotherapy were 11/21(52.4%)and 18/21(85.7%),and there was a positive correlation between the two.The difference was statistically significant.Significance(r=0.633,p<0.05);bcl-2 positive expression was correlated with tumor staging and lymph node metastasis in this case,and the differences were statistically significant(the p values were: p=0.035,p=0.030).There is a close relationship between mtdh expression and disease stage,lymph node metastasis,and efficacy evaluation(radiotherapy sensitivity),and the differences are statistically significant(the p values are: p=0.006,p=0.030,p=0.016).4.The positive rate of bcl-2 was 11/21,that of sensitive group was 5/14,that of resistant group was 6/7,that of resistant group was significantly higher than that of sensitive group,but the difference was not statistically significant(p=0.063);the high expression of mtdh was 9/21,that of sensitive group was 3/14,that of resistant group was 6/7,that of resistant group was significantly higher than that of sensitive group There was a negative correlation between the expression of bcl-2,mtdh and radiosensitivity(r=-0.472;r=-0.612).There was no correlation between radiosensitivity and age,tumor stage,tumor size,lymph node metastasis,bladder and rectum invasion(p> 0.05).5.In the concurrent chemoradiotherapy group,18 pairs of complete pathological data before and after treatment were obtained,and the expression levels of bcl-2 and mtdh in pathological tissue samples before and after treatment were detected by immunohistochemistry,and the changes in expression levels were compared before and after treatment.Because the difference in expression intensity before and after treatment with bcl-2 and mtdh did not conform to a normal distribution,a Wilcoxon signed rank sum test was used.The results are as follows: expressions before and after bcl-2 treatment: 2 cases with positive rank,6 cases with negative rank,10 cases with knot,z=-1.414;p=0.157;expressions before and after treatment with mtdh: 3 cases with positive rank,11 cases with negative rank,knot 4 For example,z=-2.122;p=0.034.Conclusions:1.The expression rate of bcl-2 and mtdh in cervical squamous cell carcinoma is high,and there is a positive correlation between them.The higher the positive rate of bcl-2 and mtdh in cervical squamous cell carcinoma with low differentiation,lymphatic vessel space invasion and lymph node metastasis,it suggests that the expression of bcl-2 and mtdh in cervical cancer may be one of the reasons to promote the occurrence and development of tumor.2.The detection of bcl-2 and mtdh is helpful for the clinical evaluation of the disease and the prediction of the early therapeutic effect(radiosensitivity),which is expected to become an important index for the prediction of the short-term therapeutic effect.