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腹腔镜根治性子宫切除术联合新辅助化疗可有效改善宫颈癌患者的免疫功能。

Laparoscopic Radical Hysterectomy Combined with Neoadjuvant Chemotherapy for Cervical Cancer Patients Effectively Improves Immune Function.

机构信息

Department of Gynecology and Obstetrics, People's Hospital Affiliated to Shandong First Medical University, Jinan 271199, Shandong Province, China.

Department of Oncology, People's Hospital Affiliated to Shandong First Medical University, Jinan 271199, Shandong Province, China.

出版信息

Dis Markers. 2022 Sep 14;2022:3611174. doi: 10.1155/2022/3611174. eCollection 2022.

Abstract

OBJECTIVE

To evaluate the clinical efficacy of neoadjuvant chemotherapy plus laparoscopic radical hysterectomy for cervical cancer and the effect on the immune function of patients.

METHODS

Between January 2021 and December 2021, 42 patients with cervical cancer diagnosed and treated at our hospital were recruited and randomly assigned at a 1 : 1 ratio to receive neoadjuvant chemotherapy plus open radical hysterectomy (control group) or neoadjuvant chemotherapy plus laparoscopic radical hysterectomy (treatment group) (study group). Outcome measures included surgical indices, clinical outcomes, and immunological function.

RESULTS

There were no significant differences in the operative time between the two groups ( > 0.05). Patients receiving laparoscopic surgery had significantly less intraoperative bleeding and shorter time lapse before postoperative anal exhaustion, time lapse before out-of-bed activities, and hospital stay versus patients receiving open surgery ( < 0.05). Laparoscopic surgery resulted in a significantly higher efficacy (90.48%) versus open surgery (57.14%) ( < 0.05). After treatment, patients in the study group showed lower levels of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and cancer antigen (CA125) than those in the control group ( < 0.05). After treatment, patients given laparoscopic surgery showed significantly lower CD, CD, and CD levels and higher CD/CD levels versus those with open surgery ( < 0.05). The postoperative conditions of the two groups, including recatheterization, postoperative blood transfusion, and secondary anti-inflammation were not significantly different ( > 0.05). The study group showed a significantly lower incidence of complications (19.05%) than the control group (71.43%) ( < 0.05). Patients in the study group had a lower reoperation rate and a higher survival rate (0.00%, 95.24%) than those in the control group (19.05%, 66.67%) ( < 0.05).

CONCLUSION

Neoadjuvant chemotherapy plus laparoscopic radical hysterectomy effectively improves clinical efficacy, lowers cancer marker levels, improves patients' immune function, reduces the risk of adverse events, and improves patients' prognosis with less intraoperative bleeding, less trauma, faster postoperative recovery, and shorter hospital stay for cervical cancer patients.

摘要

目的

评估新辅助化疗联合腹腔镜根治性子宫切除术治疗宫颈癌的临床疗效及其对患者免疫功能的影响。

方法

选取 2021 年 1 月至 12 月在我院诊治的宫颈癌患者 42 例,采用 1:1 随机分组的方法分为新辅助化疗联合开腹根治性子宫切除术(对照组)或新辅助化疗联合腹腔镜根治性子宫切除术(观察组)(研究组)。观察两组患者的手术指标、临床疗效和免疫功能。

结果

两组患者的手术时间比较,差异无统计学意义(>0.05)。观察组患者术中出血量明显少于对照组,术后肛门排气时间、下床活动时间、住院时间明显短于对照组(<0.05)。观察组患者的治疗总有效率为 90.48%,明显高于对照组的 57.14%(<0.05)。治疗后,观察组患者的癌胚抗原(CEA)、鳞状细胞癌抗原(SCC-Ag)和糖类抗原 125(CA125)水平明显低于对照组(<0.05)。治疗后,观察组患者的 CD 、CD 、CD 水平明显低于对照组,CD/CD 水平明显高于对照组(<0.05)。两组患者的导管再置率、术后输血率和二次抗炎率比较,差异无统计学意义(>0.05)。观察组患者的并发症总发生率为 19.05%,明显低于对照组的 71.43%(<0.05)。观察组患者的复发率为 0.00%(0/21),明显低于对照组的 19.05%(4/21),观察组患者的生存率为 95.24%(20/21),明显高于对照组的 66.67%(14/21)(<0.05)。

结论

新辅助化疗联合腹腔镜根治性子宫切除术治疗宫颈癌,能有效提高临床疗效,降低肿瘤标志物水平,改善患者的免疫功能,降低不良事件发生风险,提高患者的预后,且术中出血量少、创伤小、术后恢复快、住院时间短。

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Updates on systemic therapy for cervical cancer.宫颈癌系统治疗进展。
Indian J Med Res. 2021 Aug;154(2):293-302. doi: 10.4103/ijmr.IJMR_4454_20.

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