Chemoresistance-related factors for preoperative interventional chemotherapy and prognosis in bulky cervical cancer / 介入放射学杂志

ABSTRACT

Objective To identify the chemoresistant factors predicting the response to preoperative chemotherapy and clinicopathological prognosis in bulky cervical cancer. Methods 68 patients with bulky cervical carcinoma treated with two courses of intraarterial infusion of cisplatin 80mg, 5 fluorouracil(5Fu) 1500mg and AT 1258 or EADR 60mg, followed by radical hysterectomy and pelvic lymphnodenectomy at our hospital between 1996-1999 were retrospectively reviewed. Expressions of the chemoresistance related proteins, such as P glycoprotein glutathione S transferase ?(GST ?), and proliferating cell nuclear antigen(PCNA) in the tumor cells were examined by immunohistochemistry in previous biopsy specimens. These results were compared with the chemotherapeutic response obtained by gynecological examination and vagina ultrasonic. 68 patients were followed up. SPSS 8.0 was used. Results P glycoprotein expression rate was 31% and GST ? expressioin rate was 51%. There were 38 patients whose PCNA labellings were more than 50% and 30 less than 50%. The total chemotherapeutic response rate was 84%. Chemotherapeutic response rate was significantly correlated with P glycoprotein expression( P =0.013) and PCNA labelling ( P =0.001), but not GST ? expression in the tumor cells. Parautrial involvement and lymph node metastasis were independent factors for prognosis in this group. The survival rate in MDR(+) group was lower than MDR(-) group. No significant correlation between eigher the expression of GST ? or PCNA. Conclusions The expression of P glycoprotein and PCNA is potentially useful for predicting the response to preoperative chemotherapy for cervical cancer. The parautrial involvement and lymph node metastasis were independent prognostic factors for the survival rate including. the expression of P glycoprotein.