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Objective:To study the risk factors of postoperative permanent hypoparathyroidism after total thyroidectomy.Methods:In this retrospective study ,the receiver operating characteristic (ROC) curve of postoperative 24 h parathyroid hormone(PTH) values was used to predict the risk of permanent hypoparathyroidism.The clinical and pathological features that related to postoperative permanent hypoparathyroidism were studied by χ2 test and multivariate Logistic regression analysis. Results:Eight hundred and eighty-nine patients were enrolled, the incidence of postoperative transient and permanent hypoparathyroidism was 33.3% and 4.0%, respectively. When 24 h PTH levels less than or equal to 5.84 pg/ml were used as cut off value, the sensitivity of the prediction of permanent hypoparathyroidism was 100%, the specificity was 72%, and the positive predictive value was 22.5%. The presence of parathyroid gland in the pathologic specimen, parathyroid autotransplantation and PTH≤5.84 pg/ml at 24 h after operation were statistically significant risk factor for permanent hypoparathyroidism in multivariate analysis( χ2=10.900, P=0.001; χ2=4.415, P=0.044; χ2=13.576, P=0.000). Group analysis found that the lower 24 h PTH the higher incidence of permanent hypoparathyroidism. Conclusions:For patients undergoing total thyroidectomy, when parathyroid gland is involved and/or the PTH value is low at 24 h after surgery, the occurrence of permanent hypoparathyroidism is high.
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Nasopharyngeal carcinoma (NPC) is a common head and neck malignant tumor with high incidence in southern China. Local recurrence is one of the main failure modes of locally advanced NPC. The dose-escalation after radical radiotherapy for locally advanced NPC remains controversial. In the era of modern radiotherapy, the mainstream treatment mode of locally advanced NPC is neoadjuvant chemotherapy plus concurrent chemoradiotherapy. There is no consensus on whether to prescribe dose-escalation, how and when to conduct dose-escalation, how much dose to prescribe for patients with residual lesion proved by MRI or pathology. How to accurately determine the target volume and dose / fraction to maximize the local control of the tumor are the directions of clinical practice for locally advanced NPC, which remain to be further studied.
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Objective:To investigate the patterns of lateral and central neck lymph node metastasis in N1b papillary thyroid carcinoma (PTC) patients.Methods:From Jun 2018 to Sep 2020, 96 consecutive treatment-naive unilateral N1b PTC patients were included. After total thyroidectomy, bilateral central neck and unilateral lateral neck dissection (including the level Ⅱa, Ⅱb, Ⅲ, Ⅳ and Ⅴb) metastasis in different levels and pathological status of lymph nodes were analyzed.Results:The lymph node metastasis rates were 85% in ipsilateral paratracheal region, 82% in level Ⅲ, 77% in level Ⅳ, 55% in pre-tracheal region, 47% in contralateral paratracheal region, 40% in level Ⅱa, 34% in pre-laryngeal region, 6% in level Ⅱb, 6% in intermuscular region, 4% in level Ⅴb. Tumor size >1cm and pre-tracheal lymph nodes netastasis were associated with contralateral paratracheal metastasis ( OR=3.282 and 3.064, P<0.05); Metastasis to Ⅵa was associated with metastasis to Ⅵb ( OR=3.364, P<0.05). Conclusion:Level Ⅱa-Ⅳ of lateral neck and all subgroups of central neck lymph nodes tend to be involved in PTC with lateral neck metastasis. Lateral neck including level Ⅱa-Ⅳ and the whole central neck including right Ⅵb lymph nodes dissection is recommended for N1b PTC patients.
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Objective@#To observe the expression and clinical significance of galectin-1 in Chinese laryngeal squamous cell carcinoma patients.@*Methods@#Immunohistochemical technique was used to test the galecin-1 protein expression in the 50 laryngeal squamous cell carcinoma patients and Western blot method was used to test the galecin-1 protein expression in the 3 of the patients. SAS 9.4 software was used to analyze the relationship between the galectin-1 protein and the clinical degrees, pathological grades and lymph node metastasis in all the cases.@*Results@#In the 50 laryngeal squamous cell carcinoma patients, the positive rate of galectin-1 protein was 74% (37/50). The expression of galectin-1 protein was correlated with the severity of clinical staging, pathological differentiation and lymph node metastasis.@*Conclusions@#High expression of galectin protein related with the occurrence and development of head and neck squamous cell carcinomas.
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Objective@#To investigate the diagnostic performance of fine-needle aspiration (FNA) cytology for the detection of lateral lymph node metastases in patients with papillary thyroid carcinoma (PTC).@*Methods@#A total of 109 lateral lymph nodes with suspicious metastases from 85 patients were retrospectively subjected to FNAC, fine-needle aspiration thyroglobulin measurement (FNATg), and FNATg/SerumTg measurement. Lymph node pathological results after surgery were taken as the gold standard. Using Mann-Whitney U test, Pearson linear model and ROC curve were used for data analysis.@*Results@#The sensitivity, specificity and accuracy of FNATg for the diagnosis of lateral neck lymph node metastasis were respectively 93.7%, 90.0% and 93.3% and those of FNATg/SerumTg were respectively 89.9%, 90.0% and 93.2% respectively, the threshold values for FNATg and FNATg/SerumTg were 0.925 ng/ml and 1.007, respectively. The sensitivity, specificity and accuracy of FNATg combined with FNAC were respectively 91.0%,93.5% and 94.4%. The existence of thyroid tissue and the expression of serum Tg did not affect the expression of lymph node FNATg. The FNATg cutoff value of 0.925 ng/ml showed the best diagnostic performance in patients with a thyroid gland, while the FNATg/SerumTg cutoff ratio of 14.95 showed the best diagnostic performance in patients without a thyroid gland. The serum TgAb significantly interfered with the expression of FNATg in the lateral neck metastatic lymph nodes (P=0.049).@*Conclusions@#FNATg alone or the combination of FNATg with FNAC are highly reliable in the diagnosis of lateral neck lymph node metastases in patients with PTC. The expression of TgAb may interfere with the accuracy of the diagnostic performance of FNATg.
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Objective To investigate the correlation between apolipoprotein and homocysteine levels with the stability of carotid plaque and the degree of stenosis??Methods One hundred elderly patients with acute cerebral infarction from January 2017 to December 2017 were collected continuously in Harbin Fourth Hospital,All patients underwent color Doppler ultrasound examination of carotid artery??They were divided into stable plaque group and unstable plaque group according to the results of color Doppler ultrasound,then according to the degree of stenosis they were divided into intimal thickening group with 23 cases, mild stenosis (stenosis degree＜50%) with 26 cases,moderate stenosis group (50%≤stenosis degree＜70%) with 28 cases,severe stenosis group (70%≤stenosis degree) with 23 cases??All the patients were selected to collect the blood of the elbow in the early morning to detect the level of apolipoprotein B and Hcy??Results Compared with unstable plaque group, smoking, drinking, hemoglobin A1c ( HbA1c), ApoB and Hcy had significant differences (all P＜0??05)??Gender,history of diabetes mellitus,history of hypertension,systolic pressure,diastolic pressure,low density lipoprotein cholesterol (LDL?C),triglyceride (TG) There was no significant difference in total cholesterol ( TC) and total cholesterol ( all P＞0??05)??Multivariate logistic regression was performed after correcting the related risk factors excluding blood lipids??The results showed that alcohol ( OR＝ 1??247 ( 95%CI: 0??626－1??958), P＝ 0??043), Hcy ( OR＝ 3??163 ( 95%CI: 1??824 －4??772),P＝0??045), bloodpressure ( OR＝1??286 ( 95%CI: 0??688－2??005), P＝0??027), HbA1c ( OR＝3??671(95%CI: 1??904－6??630),P＝0??011),ApoB (OR＝1??717(95%CI: 1??005－2??634),P＝0??036), LDL?C(OR＝1??516(95%CI: 0??968－2??489),P＝0??024),TC( OR＝1??403( 95%CI: 0??801－2??343),P＝0??030) and TG ( OR＝1??342 ( 95%CI: 0??712－2??198), P＝0??019) are independent risk factors for unstablecarotid plaque and severe carotid stenosis??Conclusion Apolipoprotein and homocysteine may be independent predictors of unstable carotid plaque and severity of carotid stenosis??
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Objective@#To study the diagnostic value of a multi-gene molecular testing in cytologically indeterminate thyroid nodules.@*Methods@#From February 2018 to September 2018, patients with thyroid nodules who underwent fine needle aspiration(FNA) at Peking University Cancer Hospital were enrolled. Three hundred and sixty patients were included, consisting of 86 men and 274 women, with a mean age of 45.8 years (between 13 and 89 years old). Among 391 nodules, 141 were cytologically inderminate and 75 were resected. FNA samples underwent prospective testing using a next-generation sequencing (NGS) assay, which included 16 genes for point mutations and 26 types of gene fusions. The testing results of indeterminate nodules were compared with surgical outcomes, to determine the diagnostic performance. The results were compared with the BRAF V600E single gene mutation analysis by χ2 test.@*Results@#The multi-gene testing showed a sensitivity of 73.2%, specificity of 96.8%, positive predictive value of 96.8%, and negative predictive value of 73.2%. The diagnostic accuracy of multi-gene testing was significantly higher than the BRAF V600E mutation test (83.3% vs 73.6%, χ2=31.588, P<0.01).@*Conclusion@#Multi-gene testing in FNA samples is an effective method to diagnose cytologically indeterminate thyroid nodules, which has a higher accuracy than BRAF V600E mutation detection.
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Objective@#To synthesize and analyze 18F-prostate specific membrane antigen (PSMA)-1007, followed by its imaging in prostate cancer.@*Methods@#Based on one-step method, 18F-PSMA-1007 was produced by the CFN-MPS-200 automatic synthesis module and its quality analysis was conducted. 18F-PSMA-1007 PET/CT imaging was performed in a prostate cancer patient (66 years old).@*Results@#The synthesis time of 18F-PSMA-1007 was about 50 min, and the radiochemical yield was (25.0±5.0) % (attenuation correction, n=3). The radiochemical purity was above 99.0% and was above 98.0% after 6 h. The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (410.0±11.0) MBq/ml and the radioactive nuclear purity was above 99.0%. PET/CT imaging in the patient showed that 18F-PSMA-1007 was highly concentrated in prostate cancer with maximum standardized uptake value (SUVmax) of 40.9.@*Conclusion@#Based on CFN-MPS-200 multifunction synthesis module, 18F-PSMA-1007 can be stably synthesized with high radiochemical yield and can be concentrated in prostate cancer.
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Objective To synthesize and analyze 18 F-prostate specific membrane antigen ( PSMA)-1007, followed by its imaging in prostate cancer. Methods Based on one-step method, 18 F-PSMA-1007 was produced by the CFN-MPS-200 automatic synthesis module and its quality analysis was conducted. 18 F-PSMA-1007 PET/CT imaging was performed in a prostate cancer patient (66 years old). Results The syn-thesis time of 18F-PSMA-1007 was about 50 min, and the radiochemical yield was (25.0±5.0) ％ (attenua-tion correction, n=3). The radiochemical purity was above 99.0％ and was above 98.0％ after 6 h. The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (410.0± 11.0) MBq/ml and the radioactive nuclear purity was above 99.0％. PET/CT imaging in the patient showed that 18 F-PSMA-1007 was highly concentrated in prostate cancer with maximum standardized uptake value ( SUVmax ) of 40.9. Conclusion Based on CFN-MPS-200 multifunction synthesis module, 18 F-PSMA-1007 can be stably synthesized with high radiochemical yield and can be concentrated in prostate cancer.
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Objective@#To analyze the infection of human papillomavirus and expression of p53 in patients with hypopharynx squamous cell carcinoma.@*Methods@#The pathological samples of 15 clinically diagnosed hypopharynx cancer patients were collected. Lunimex and PCR techniques were used to detect the human papillomavirus (HPV) gene and immunohistochemical method was used to analyze the HPV protein expression in the samples. PCR and direct sequencing were used to screen the mutations in p53 gene and immunohistochemistry was used to evaluate the expressing profiles of p53 proteins.@*Results@#In the 15 cases, 6 were positive for HPV16/18 gene and 2 cases were positive for HPV16/18 E6 protein expression. The total positive rate was about 46.7% (7/15). In addition, 9 of 15 (60.0%) cases had sequencing-confirmed p53 mutations and p53 immunohistochemistry (IHC) confirmed 9 (60.0%) cases had positive staining.@*Conclusions@#The high HPV infection rate and p53 expression in hypopharynx squamous cell carcinoma patients in the study lays a foundation for further elucidating the pathogenesis of this kind of cancer.
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Objective To investigate the effect of diabetes on clinical efficacy of transcatheter arterial chemoembolization (TACE) in the treatment of non-viral hepatitis hepatocellular carcinoma (HCC). Methods Retrospectively analyzed the clinical data of 367 non-hepatitis virus HCC patients treated by TACE, included 153 diabetes mellitus cases (test group) and blood glucose of 214 patients was normal (control group). To assess the treatment effect after 1 month of TACE based on response evaluation criteria in solid tumors, include complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), and calculate the disease control rate. Through 6 to 75 months follow-up to observed long-term efficacy, record the time to progression (TTP) and overall survival (OS) time. Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis by SPSS 16.0. The single-factor analysis was used to analyze variables which variables that differed were analyzed by Cox regression. Results The disease control rate of test group was 69.9%(107/153) and control group was 74.3%(159/214), the difference was no statistically significant (P=0.125). The median time to progression (mTTP) and median overall survival (mOS) of test group were 10.0 and 15.0 months;and the mTTP and mOS of control group were 14.0 and 19.0 months, the difference were statistically significant (P=0.023 and P= 0.026). Tumor diameter ≥4.5 cm, numbers of tumor ≥3, invasion of blood vessels, α-fetoprotein≥200 μg/L, Eastern Cooperative Oncology Group score and diabetes were risk factors for OS of HCC patients. Conclusion Diabetes is unfavorable factors for overall survival of non-hepatitis HCC tread by TACE.
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Objective To study the curative effect and safety of percutaneous vertebroplasty (PVP)assisted by bone filling mesh container for the treatment of spinal metastases with vertebral posterior wall destruction.Methods A total of 31 patients with spinal metastasis (43 metastatic vertebrae in total) received PVP with the help of bone filling mesh container.The primary tumors were definitely confirmed in all patients.Visual analogue scale (VAS) was used to evaluate the pain degree at one day before PVP,and at one and 3 days,one and 3 months after PVP as well as at the last follow-up visit.Oswestry dysfunction index (ODI)was adopted to assess patient's activity function status.The occurence of postoperative bone cement leakage was recorded.Results PVP was successfully accomplished for all 43 involved vertebrae,with a technical success rate of 100％.The mean preoperative VAS score was (8.2±0.4) points,which was decreased to (2.5±0.7) points in one day after PVP.The preoperative VAS scores were higher than all the postoperative VAS scores which were determined at one and 3 days,one and 3 months after PVP as well as at the last follow-up visit,and the differences were statistically significant (P＜0.05 for all).All postoperative ODI values were significantly lower than corresponding preoperative ones (P＜0.05).After the treatment,the patient's activity function status was obviously improved.Postoperative imaging examination,including DSA and CT,indicated that no serious leakage of bone cement was observed in all patients.Conclusion With the help of bone filling mesh container,the performance of PVP for spinal metastases with vertebral posterior wall destruction is safe and reliable.Clinical satisfactory analgesic effect can be promptly achieved and the patient's activity function can be effectively improved.
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Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.
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Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.
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Objective To compare the efficacy and side-effects of preoperative neoadjuvant uterine arterial chemoembolization and venous chemotherapy in treating cervical cancer in young female patients. Methods A total of 241 young females(≤35 years old) with cervical cancer were enrolled in this study. The clinical data were retrospectively analyzed. The patients were divided into group A (n=63) and group B (n=57). Patients in group A received preoperative neoadjuvant uterine arterial chemoembolization with subsequent surgery, while patients in group B were treated with preoperative neoadjuvant intravenous chemotherapy followed by surgery. The chemotherapy scheme included carboplatin (50 mg/m2) and gemcitabine (1 000 mg/m2). The short-term effect, the amount of blood loss during the surgery, pathological findings and the side-effects of the two groups were compared. The Kaplan-Meier method was used to calculate survival rate, and the log-rank test was used for survival difference analysis. Results The short-term response rate of group A was 90.5%, which was significantly higher than that of group B (71.9%), the difference between the two groups was statistically significant (χ2=7.5, P0.05). In both groups, the clinical stage, the pathological grade and the size (≥ 4 cm) of the tumor were the main factors that could influence the prognosis in young females with cervical cancer (P<0.05). Conclusion The short-term efficacy of preoperative uterine artery chemoembolization is better than that of preoperative intravenous chemotherapy for the treatment of cervical cancer in young female patients. Besides, this therapy carries mild side effect, and it can improve the 5-year progression-free survival rate, although the long-term survival rate has not been obviously improved.
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Objective To investigate the application of colostomy care products in managing the leakage around PTCD drainage tube, and to discuss its clinical effect. Methods A total of 56 patients with malignant obstructive jaundice, who had received PTCD and suffered from postoperative leakage around PTCD drainage tube, were randomly and equally divided into the study group (n=28) and the control group (n=28). The colostomy care powder, the skin protective film and the colostomy bag were used for the patients of the study group, while iodophors, sterile gauze and mupirocin ointment were employed for the patients of the control group. The incidence of irritant dermatitis around PTCD drainage tube, the degree of comfort to the indwelling tube judged by the patient, and the nursing workload for PTCD drainage tube were determined, and the results were compared between the two groups. Results The incidence of irritant dermatitis around PTCD drainage tube in the study group was obviously lower than that in the control group. And the degree of comfort to the indwelling tube judged by the patient in the study group was much higher than that in the control group. The differences between the two groups were statistically significant (P<0.05). Conclusion Combination use of colostomy care powder, skin protective film and colostomy bag can effectively reduce the incidence of irritant dermatitis around PTCD drainage tube and improve the patient’s condition. Therefore, this method is worthy of popularization in clinical practice.
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OBJECTIVE:To investigate the effects of quercetin on human lung cancer NCI-H1395 cell apoptosis. METHODS:CCK-8 was used to detect the effects of 0-200 μmol/L quercetin on human lung cancer NCI-H1395 cell proliferation after treated for 12,24 and 48 h. Hochest33258 staining and flow cytometry were used to detect the effects of 0,20,50,100 μmol/L quercetin on NCI-H1395 cell apoptosis after treated for 24 h. The effects of 100 μmol/L quercetin on NCI-H1395 cell apoptosis was investi-gated after treated with Caspase-8,Caspase-9,Caspase-3 inhibitor. RESULTS:Quercetin could inhibit NCI-H1395 cell prolifera-tion in dose and time-dependent manner. 20,50,100 μmol/L quercetin could induce the apoptosis of NCI-H1395 cell,and apoptot-ic rates were (18.6 ± 4.1)%,(39.1 ± 4.5)% and (58.2 ± 3.5)%. Caspase-8 and Caspase-3 activation inhibition could obviously weaken the inhibitory effects of quercetin on cell(P<0.05). CONCLUSIONS:Quercetin can inhibit NCI-H1395 cell proliferation and induce cell apoptosis,which is related to the external way of cell apoptosis through activating Caspase-8 and Caspase-3.
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In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly presented as a large solid, well-defined and hypervascular mass with necrosis or cystic changes at some extents together with the displacement of adjacent structures. The radial area with hypointensity on T2-weighted image and with progressive enhancement on enhanced magnetic resonance imaging is an important feature of SFT, which can be helpful for the diagnosis of this mass.
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Humanos , Imagen por Resonancia Magnética , Recurrencia Local de Neoplasia , Pelvis , Patología , Estudios Retrospectivos , Tumores Fibrosos Solitarios , Diagnóstico , Patología , Tomografía Computarizada por Rayos XRESUMEN
Objective To investigate the clinical therapeutic effect of comprehensive treatment in young women with cervical car-cinoma.Methods A total of 52 young women with cervical carcinoma were treated with uterine artery chemoembolization.50 cases underwent radical hysterectomy and pelvic lymphadenectomy after interventional therapy.The patients with pathological risk factors were given supplementary radiotherapy.Results The clinical overall response rate was 88.5%.96.2% of patients underwent sur-gery and lymph node metastasis rate was 26.9%.The 2,5 year overall survival rates of patients were 91.5%,71.2% respectively. Conclusion The comprehensive treatment can improve overall survival rate and quality of life for young woman with cervical carci-noma.Postoperative patients with pathologically related risk factors should be treated with supplement chemoradiotherapy.
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Objective To investigate the efficacy of uterine artery chemoembolization in the treatment of locally advanced cervical cancer.Methods A total of 268 patients with locally advanced cervical cancer were treated with uterine artery chemoembolization in our department.The stage distribution among the patients included 132 stage Ⅰ B2,85 stage Ⅱ A1 and 51 stage Ⅱ A2.There were 223 patients of squamous cell carcinoma,24 patients of adenocarcinoma,9 patients of adenosquamous carcinoma,small cell carcinoma of the 7 patients,5 patients of neuroendocrine carcinoma.Transcatheter uterine artery infusion of paclitaxel and nedaplatin,gelatin sponge particles was applied for uterine artery embolization.The clinicopathological parameters were analyzed,and their impacts on tumor response were investigated.RECIST criteria were used to evaluate the response in solid tumors.Student t test was used to compare cervical tumor diameter before and after treatment,and Chi-square test was used for comparison of categorical data.Follow up examinations included pelvic ultrasound,gynecology,vaginal stump cell smears.Results Of the 268 patients,74 (27.6％) patients showed a complete response,160 (59.7％) patients had a partial response to uterine artery chemoembolization,and the overall response rate was 87.3％.A total of 258 (96.3 ％) patients underwent surgery,and pathological complete response were identified in 46 (17.2％).Forty (14.9％) patients were found to have lymph node metastasis after surgery.Response rates of stage Ⅰ B2 and Ⅱ A cases were 94.7％ and 80.1％,respectively,P ＜ 0.05.Patients with squamous cell carcinoma showed a better response rate than patents with other pathological types (94.2％ vs.53.3％),P ＜ 0.05.Initial tumor volume and cycles of preoperative uterine artery chemoembolization had no effect onthe response rate.Conclusions Uterine artery chemoembolization can increase the rate of surgical resectionof patients with locally advanced cervical cancer and can improve the reaction rate with tolerable side effect.It is an applicable option of treatment for patients with locally advanced cervical cancer in the neoadjuvanttreatment.