李炜霞

[摘要] 目的 分析不同化療途径治疗的宫颈癌患者经PI3K/AKT信号通路采用顺铂及紫杉醇脂质体治疗的效果。 方法 选择2017年9月至2018年6月在本院进行宫颈癌化疗的患者70例，按照随机数字表法分为A组（35例）及B组（35例），每组患者均使用顺铂及紫杉醇脂质体进行化疗，其中A组患者通过静脉滴注方式用药，B组患者通过动脉灌注方式用药。采集全部患者的宫颈癌组织进行检查，比较两组患者肿瘤组织中PI3K及AKTmRNA的表达情况，治疗总有效率，1年、2年无病生存率，中位无病生存时间及不良反应发生情况。 结果 B组肿瘤组织中PI3K及AKTmRNA的表达均低于A组，差异有统计学意义（P<0.05）;A组与B组患者治疗总有效率分别为77.14%、94.29%，差异有统计学意义（P<0.05）;A组与B组患者2年无病生存率分别为82.86%、97.14%，差异有统计学意义（P<0.05）;B组平均无病生存时间长于A组，差异有统计学意义（P<0.05）;B组免疫力下降、骨髓抑制、过敏反应及胃肠道反应发生率均低于A组，差异有统计学意义（P<0.05）。 结论 宫颈癌患者使用顺铂和紫杉醇脂质体经动脉灌注方式实施化疗，可提升治疗效果、减少不良反应，安全性较高，PI3K/AKT信号通路有望成为宫颈癌治疗新方向。

[关键词] 宫颈癌;化疗;PI3K/AKT信号通路;顺铂;紫杉醇脂质体

[Abstract] Objective To analyze the effects of cisplatin and paclitaxel liposomes in patients with cervical cancer treated by different chemotherapy pathways via PI3K/AKT signaling pathway. Methods A total of 70 patients who received chemotherapy for cervical cancer in our hospital from September 2017 and June 2018 were selected as the objects. According to the random number table method， they were divided into group A （35 cases） and group B （35 cases）. The patients in both groups were treated with cisplatin and paclitaxel liposome for chemotherapy. The patients in group A received drugs via intravenous drip， and group B received drugs via arterial infusion. The cervical cancer tissues from all patients were collected for examination. The expressions of PI3K and AKTmRNA in the tumor tissues were compared in the two groups of patients. The total effective rate of treatment， the one-year and two-year disease-free survival rate （DFSR）， the median disease-free survival time （DFST） and the adverse reactions（ARs） were compared between two groups. Results In tumor tissues， the expressions of PI3K and AKTmRNA in group B were significantly lower than those in group A（P<0.05）. The total effective rates of treatment for patients in group A and group B were 77.14% and 94.29%， respectively， the difference was statistically significant（P<0.05）. The two-year DFSR of patients in group A and group B were 82.86% and 97.14%， respectively， the difference was statistically significant（P<0.05）. In terms of average DFST， group B was significantly longer than group A（P<0.05）. In terms of immunity， bone marrow suppression， allergic reactions and gastrointestinal reactions， group B was significantly lower than group A（P<0.05）. Conclusion The intra-arterial infusion of cisplatin and paclitaxel liposomes can improve the therapeutic effect， and reduce adverse reactions for cervical cancer patients， with higher safety. In addition， the PI3K/AKT signaling pathway is expected to become a new direction for the treatment of cervical cancer.

[Key words] Cervical cancer; Chemotherapy; PI3K/AKT signaling pathway; Cisplatin; Paclitaxel liposomes

宫颈癌是女性常见的恶性肿瘤，其主要出现在子宫颈位置[1]。早期患者大多無明显临床表现，一般在疾病筛查时才会被检出;伴随疾病的进一步发展，患者可有接触性出血及阴道异常出血等临床表现;当处于疾病晚期时，因肿瘤对宫颈周围组织或器官造成侵犯，会使患者出现肛门坠胀感、腿部肿胀、肾功能损伤及阴道大出血等临床表现，对患者生命安全造成严重威胁[2-3]。因此，在疾病早期及时采取有效措施进行治疗，对改善疾病预后具有积极意义。当前临床对于宫颈癌通常采用根治性手术、放射及化学药物治疗，其中根治性手术对于早期患者可发挥良好的治疗效果，但是对于肿瘤体积较大且存在炎症及坏死等情况的患者，需要采取放射或化学药物治疗[4]。……