目的 探讨贵州地区进行宫颈癌机会性筛查的价值。 方法 回顾性分析2010年11月－2011年10月贵州省人民医院妇科门诊及住院进行宫颈癌机会性筛查的1 842例患者资料，筛查方法包括液基细胞学技术、宫颈刮片、人乳头瘤病毒（HPV）分型检测、HPV第2代捕获杂交法检测、阴道镜检查，以病理确诊宫颈癌前病变及宫颈癌。 结果 贵州地区女性人群的HPV平均感染率为21.87%。共检出宫颈癌前病变39例（2.12%），宫颈癌2例（0.11%）。 结论 医院内就诊女性宫颈病变检出率高，应高度重视其机会性筛查，有助于早期干预治疗。
目的 探讨宫颈癌漏诊的原因及特点，提高首诊诊断率。 方法 回顾性分析2009年1月－2011年3月收治的外院漏诊的65例宫颈癌患者临床资料。 结果 漏诊的65例中有51例误诊为宫颈糜烂，其中仅13例首诊曾行细胞学筛查，16例行阴道镜检查及活检，总平均年龄仅39岁，农村居民54例。 结论 各地区应加强宫颈癌筛查意识，采取相应措施及适合的筛查方式提高宫颈癌筛查率，减少漏诊。
探讨宫颈癌中EphA2的表达及其临床意义。方法:应用免疫组织化学方法检测10例慢性宫颈炎、25例宫颈上皮内瘤样变（CIN）、50例宫颈癌（鳞癌41例、腺癌9例）中EphA2的蛋白表达。并对50例宫颈癌患者进行8～46月随访，分析EphA2在宫颈癌中的表达与患者预后的关系。结果:慢性宫颈炎、CIN、宫颈癌组织中EphA2蛋白阳性表达的差异有统计学意义（P＜0.05）。EphA2蛋白在宫颈癌中的表达与患者年龄、FIGO分期、病理类型无关，与病理分级、有无淋巴结转移有密切相关性，且EphA2蛋白表达越强，患者生存率越低。结论：EphA2与宫颈癌的侵袭、转移密切相关，可望作为判断宫颈癌患者预后的参考指标。
Objective To investigate the expression of COX-2 in human cervical cancer and explore their relationship between the COX-2 expression and the clinicopathologic characteristic of cervical cancer. Methods The published studies were searched in the CBMdisc (1979 to 2009), CNKI (1979 to 2009), VIP (1989 to 2009) and WANFANG Database (1982 to 2009), and other relevant journals were also hand searched, to identify all the relevant case-control trials. The quality of the included studies was assessed. The Cochrane Collaboration’s software RevMan 4.2.10 was used to test the heterogeneity, overall effect and publication bias of the combined studies. Results A total of 9 studies were recruited. As for the positive rate of COX-2 expression, significant differences was tested between cervical cancer vs. normal cervical tissues, lymph node metastasi vs. non-lymph node metastasi, clinical stages I-II vs. clinical stages III-IV, cell differentiation G1 vs. cell differentiation G2-G3 and cervical squamous cell carcinoma vs. adenocarcinoma with OR (95%CI) at 28.03 (9.53 to 82.50), 5.16 (3.36 to 7.93), 0.53 (0.33 to 0.84), 3.11 (1.86 to 5.22) and 5.00 (2.68 to 9.35) respectively. Conclusions According to the domestic evidence, higher COX-2 expression might be associated with cervical cancer. However, more high quality case-control studies are expected for further study.
ObjectivesTo compare the efficacy and safety of weekly nedaplatin compared with weekly cisplatin as postoperative concurrent chemoradiotherapy scheme for cervical cancer patients.MethodsThis trial was performed in the Department of Radiation Oncology in the Second Affiliated Hospital of Fujian Medical University from June 2016 to January 2017. A total of 200 patients with stage ⅠB1-ⅡB cervical cancer were randomly assigned to the nedaplatin group and the cisplatin group after signing informed content. The dose of nedaplatin or cisplatin ranged 35 to 40 mg/m2, once a week for 5 weeks. Intensity-modulated radiation therapy or three-dimensional conformal radiation therapy were used for patients. The progression-free survival, overall survival and adverse reactions were compared between two groups. Statistical analysis was performed by SPSS 24.0 software.ResultsA total of 105 patients were enrolled in the nedaplatin group, and 95 patients were in cisplatin group. The three-year progression-free survival rate was 80.5% vs. 79.5% in the nedaplatin group and the cisplatin group, respectively; and no statistical significant difference was found (χ2=0.198, P=0.656) between two groups. The 3-year overall survival rates were 72.5% and 69.9% for the nedaplatin group and the cisplatin group, respectively, and there was no significant difference between the two groups (χ2=0.261, P=0.609). The incidence of grade 3/4 nausea and vomiting in the nedaplatin group was 6.67%, which was significantly lower than that of 15.79% in the cisplatin group, and statistical significant difference was found (χ2=2.555, P=0.011); however, the incidence of grade 3/4 thrombocytopenia in the nedaplatin group was 9.52%, which was significantly higher than that in the cisplatin group (3.15%); and the difference was statistically significant (χ2=1.985, P=0.047). There was no difference in the incidence of adverse reactions such as anemia, neutropenia, and radiological proctitis in both groups.ConclusionsNedaplatin-based concurrent chemoradiotherapy has similar efficacy compared to cisplatin-based concurrent chemoradiotherapy, and it could significantly reduce the digestive tract reaction, which can be used as an alternative to cisplatin.
【摘要】 目的 探讨宫颈上皮内瘤变（CIN）和宫颈鳞癌（SCC）组织中人类染色体端粒酶基因（hTERC）的表达和临床意义。 方法 收集2007年10月-2009年6月经病理学证实的116例宫颈脱落细胞标本，其中LSIL（CINⅠ）30例、HSIL（CINⅡ/Ⅲ）37例、SCC 16例、宫颈炎33例，用荧光原位杂交（FISH）方法检测脱落细胞hTERC基因。 结果 在宫颈炎、LSIL、HSIL和SCC组中hTERC基因的表达率分别是6.1%、16.7%、51.4%和93.8%，其中，HSIL、SCC组与宫颈炎组比较，hTERC基因阳性率差异有统计学意义（Plt;0.05），LSIL组与HSIL组比较、LSIL组与SCC组比较、HSIL组与SCC组比较，差异有统计学意义（Plt;0.05），且随着病变程度增加，hTERC基因表达率增加。 结论 hTERC基因在细胞学LSIL、HSIL和SCC中表达异常，且随病变程度增加阳性表达率也增加，可作为宫颈癌癌前病变进展的生物遗传学监测指标，并有望成为宫颈癌早期筛查方法之一。【Abstract】 Objective To explore the clinical significance and expression of the human telomerase gene (hTERC) in the cervical intraepithelial neoplasia (CIN) and squamous carcinoma of the cervix (SCC). Methods According to histological biopsy from October 2007 to June 2009, 116 pap smears were divided into LSIL (n=30), HSIL (n=37), SCC (n=16), and cervicitis (n=33) groups. Fluorescence in situ hybridization (FISH) was used to detect the expression of hTERC. Results Positive expression rate of hTERC was 6.1% in cervicitis group, 16.7% in LSIL group, 51.4% in HSIL group, and 93.8% in SCC group, respectively. Compared to cervicitis group, the expression of hTERC in HSIL and SCC groups was significantly higher (Plt;0.05). Among LSIL, HSIL, and SCC groups, there were significant differencec in hTERC expression between every two groups (Plt;0.05). From LSIL to SCC, the expression of hTERC increased obviously. Conclusion Abnormal expression of hTERC exists in LSIL, HSIL, and SCC patients, which significantly increases during malignant development. It may be a biogenetics monitor index of cervical precancerosis and will be a screening marker for cervical cancer.