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新辅助化疗联合腹腔镜根治性手术并给予优质护理对宫颈癌患者临床疗效及性激素的影响

Effects of neoadjuvant chemotherapy combined with radical laparoscopic surgery with quality nursing care on clinical efficacy and sex hormones in patients with cervical cancer.

作者信息

Hu Haifeng, Wang Zhishang, Xue Lanhui, Zhang Tongmei, Jing Yanru, Li Yawen

机构信息

Department of Oncology, Yanan University Affiliated Hospital Yan'an 716000, Shaanxi, China.

Department of Oncology, Yanan City Hospital of TCM Yan'an 716000, Shaanxi, China.

出版信息

Am J Transl Res. 2024 Feb 15;16(2):477-486. doi: 10.62347/NKJK1347. eCollection 2024.

Abstract

OBJECTIVE

To observe the effects of neoadjuvant chemotherapy combined with radical laparoscopic surgery with quality nursing care on the clinical efficacy and sex hormones of cervical cancer patients.

METHODS

The clinical data of 107 patients with cervical cancer admitted to Yanan University Affiliated Hospital between January 2017 and January 2020 were retrospectively analyzed in this study. Among them, 50 patients received only laparoscopic radical surgery (surgical group), and the other 57 received neoadjuvant chemotherapy combined with laparoscopic radical surgery (Joint group); patients in both groups received quality nursing care. The baseline and surgical data of the two groups were compared, and the changes in tumor markers and sex hormones before and after treatment were analyzed. Cox regression was used to analyze the independent prognostic factors affecting patients' 2-year survival.

RESULTS

The patients in the two groups did not show statistical differences in baseline and surgical data (all P > 0.05). After treatment, the levels of squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and serum glycan antigen 125 (CA125) were significantly reduced in both groups. However, the reduction was more pronounced in the joint group than that in the surgical group (P < 0.0001). Meanwhile, estrogen (E2) levels decreased more significantly in the Joint group, while follicle-stimulating hormone (FSH) and luteinizing hormone (LH) increased more significantly (all P < 0.0001). Multifactorial Cox regression analysis revealed that E2, LH and SCC-Ag were independent prognostic factors affecting 2-year survival (all P < 0.05).

CONCLUSION

Neoadjuvant chemotherapy combined with laparoscopic radical surgery is more effective in reducing the levels of tumor markers and significantly affects the levels of sex hormones. E2, LH, and SCC-Ag are the independent prognostic factors for 2-year survival in patients with cervical cancer. This study provides evidence to support the comprehensive treatment of cervical cancer.

摘要

目的

观察新辅助化疗联合腹腔镜根治性手术并给予优质护理对宫颈癌患者临床疗效及性激素的影响。

方法

本研究回顾性分析了2017年1月至2020年1月延安大学附属医院收治的107例宫颈癌患者的临床资料。其中,50例患者仅接受腹腔镜根治性手术(手术组),另外57例接受新辅助化疗联合腹腔镜根治性手术(联合组);两组患者均接受优质护理。比较两组患者的基线和手术数据,并分析治疗前后肿瘤标志物和性激素的变化。采用Cox回归分析影响患者2年生存的独立预后因素。

结果

两组患者的基线和手术数据无统计学差异(均P>0.05)。治疗后,两组患者的鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)和血清糖链抗原125(CA125)水平均显著降低。然而,联合组的降低幅度比手术组更明显(P<0.0001)。同时,联合组雌激素(E2)水平下降更显著,而促卵泡生成素(FSH)和促黄体生成素(LH)升高更显著(均P<0.0001)。多因素Cox回归分析显示,E2、LH和SCC-Ag是影响2年生存的独立预后因素(均P<0.05)。

结论

新辅助化疗联合腹腔镜根治性手术在降低肿瘤标志物水平方面更有效,并显著影响性激素水平。E2、LH和SCC-Ag是宫颈癌患者2年生存的独立预后因素。本研究为支持宫颈癌的综合治疗提供了依据。

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