王荣华

【摘要】 目的：探讨术前新辅助化疗（NACT）治疗局部晚期宫颈癌（LACC）的效果。方法：以2018年1-12月笔者所在医院接受的96例LACC患者作为本次研究对象。按入院先后顺序将其分为对照组和观察组，各48例。对照组患者实施直接手术治疗，观察组实施NACT+手术治疗。比较两组治疗效果。结果：观察组治疗总有效率为77.08%，高于对照组的60.42%，差异有统计学意义（P<0.05）。观察组手术时间、术中出血量均优于对照组，差异有统计学意义（P<0.05）。治疗前，两组患者血清诱捕受体3（DcR3）、凋亡抑制基因（Survivin）、血管内皮生长因子（VEGF-C）水平比较，差异均无统计学意义（P>0.05）;治疗后，观察組DcR3、Survivin、VEGF-C水平均低于对照组，差异有统计学意义（P<0.05）。观察组不良反应发生率为16.67%，显著低于对照组的35.42%，差异有统计学意义（P<0.05）。结论：对LACC患者实施NACT治疗，可缩短手术时间，降低术中出血量，降低血清DcR3、Survivin、VEGF-C水平，有效提高临床治疗效果。

【关键词】 术前; 新辅助化疗; 局部晚期宫颈癌; 有效率; 不良反应

doi：10.14033/j.cnki.cfmr.2019.27.012 文献标识码 B 文章编号 1674-6805（2019）27-00-03

Clinical Observation of Preoperative Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer/WANG Ronghua.//Chinese and Foreign Medical Research，2019，17（27）：-28

【Abstract】 Objective：To investigate the effect of preoperative neoadjuvant chemotherapy（NACT） in the treatment of locally advanced cervical cancer（LACC）.Method：A total of 96 LACC patients admitted in our hospital from January to December 2018 were selected as the study subjects.According to the order of admission，the patients were divided into the control group and the observation group，with 48 cases in each group.The control group received direct surgical treatment，while the observation group received NACT and surgical treatment.The therapeutic effects of the two groups were compared.Result：The total effective rate of the observation group was 77.08%，which was higher than 60.42% of the control group，and the difference was statistically significant （P<0.05）.The operative time and intraoperative blood loss in the observation group were better than those in the control group，and the differences were statistically significant（P<0.05）.Before treatment，there were no significant differences in serum levels of entrapment receptor 3（DcR3），apoptosis suppressor gene（Survivin），and vascular endothelial growth factor（VEGF-C） between the two groups（P>0.05）.After treatment，DcR3，Survivin，and VEGF-C levels in the observation group were all lower than those in the control group，the differences were statistically significant（P<0.05）.The incidence of adverse reactions in the observation group was 16.67%，which was significantly lower than 35.42% in the control group，and the difference was statistically significant（P<0.05）.Conclusion：NACT treatment for LACC patients can shorten the operation time，reduce intraoperative blood loss，and reduce serum DcR3，Survivin，and VEGF-C levels，effectively improving the clinical efficacy.

【Key words】 Preoperative; Neoadjuvant chemotherapy; Locally advanced cervical cancer; Efficient; Adverse reactions

First-authors address：Wuhan Xinzhou District Hospital of Traditional Chinese Medicine，Wuhan 431400，China

宫颈癌在临床上尤为常见，是一种常见的恶性肿瘤，其发病率较高，具有极高的死亡率，已经成为威胁女性生命健康的重要疾病。局部晚期宫颈癌（LACC）则是指患者局部肿瘤的直径超过4 cm，臨床分期为ⅠB2～ⅡA2的患者[1]。临床上，针对早期患者主要是采用手术的方式进行治疗，而针对LACC的治疗中，鉴于患者病情较为严重，极容易发生淋巴转移现象，在这种情况下，单纯采用手术治疗，常常会导致患者出现术中出血量过多、术后并发症风险高等现象。而在最新的研究中发现，在对LACC患者实施手术治疗前，通过术前新辅助化疗（NACT）治疗，则可有效减轻肿瘤的负荷，并提高手术治疗效果[2-3]。为了进一步研究NACT治疗LACC的效果，以2018年1-12月笔者所在医院接收的96例LACC患者作为本次研究对象，并将研究结果进行如下总结。

1 资料与方法

1.1 一般资料

以2018年1-12月笔者所在医院接受的96例LACC患者作为本次研究对象。纳入标准：（1）均经病理学诊断证实;（2）病理分期为ⅠB2～ⅡA2，肿瘤直径为4～10 cm。……