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目的宫颈癌新辅助化疗(neoadjuvant chemotherapy,NACT)的疗效一直存在争议,PI3K/AKT通路在肿瘤细胞增殖、迁移、侵袭及抗凋亡都起到举足轻重的作用。本研究探讨NACT对宫颈鳞状细胞癌AKT通路中AKT及P-AKT的表达对肿瘤微淋巴管生成的影响,并分析其变化与NACT临床疗效的关系。方法采用免疫组化SP法分别检测2011-03-01-2016-03-31滨州医学院附属医院收治的47例ⅠB2~ⅡB期宫颈鳞癌患者行NACT前后AKT和P-AKT的表达情况及肿瘤微淋巴管密度(lymphatic microvessel density,LMVD)的变化。结果免疫组化检测结果显示,NACT前AK和P-AKT的阳性率分别为93.6%和72.3%,化疗后阳性率分别为44.7%和36.2%,NACT前后比较,AKT和P-AKT表达差异有统计学意义,P<0.001。化疗前宫颈鳞癌组织中LMVD计数为20.87±3.31,化疗后宫颈鳞癌组织中LMVD计数为16.47±3.44,化疗后宫颈鳞癌组织中LMVD明显降低,t=6.32,P<0.001。化疗前宫颈鳞癌AKT阳性的LMVD为21.14±3.19,高于阴性组(17.00±3.00)。Spearman相关分析显示,化疗前后LMVD的表达(r_s=0.39,P=0.007)与化疗前后P-AKT的表达(r_s=0.66,P<0.001)均呈正相关。化疗后LMVD与化疗后AKT的表达呈正相关,r_s=0.58,P<0.001。淋巴结转移与化疗前后LMVD均呈正相关(r_s=0.44,P<0.001;r_s=0.36,P=0.013)。淋巴结转移的患者化疗前化疗后LMVD均高于淋巴结未转移者。结论化疗前P-AKT的表达及化疗后AKT和P-AKT的表达与肿瘤微淋巴管生成呈正相关,LMVD与淋巴结的转移呈正相关,化疗前P-AKT的表达有可能作为预测宫颈癌新辅助化疗疗效的指标。
Purpose The efficacy of neoadjuvant chemotherapy (NACT) has been controversial. The PI3K / AKT pathway plays a pivotal role in the proliferation, migration, invasion and apoptosis of tumor cells. This study was to investigate the effect of NACT on the expression of AKT and AKT in AKT pathway of cervix squamous cell carcinoma on lymphangiogenesis and to analyze its relationship with the clinical efficacy of NACT. Methods The immunohistochemical SP method was used to detect the expression of AKT and P-AKT before and after NACT in 47 cases of stage ⅠB2 ~ ⅡB cervical squamous cell carcinoma admitted to Affiliated Hospital of Binzhou Medical College 2011-03-01-2016-03-31 Changes in lymphatic microvessel density (LMVD). Results The positive rates of AKT and P-AKT before NACT were 93.6% and 72.3% respectively. The positive rates after chemotherapy were 44.7% and 36.2% respectively. There were significant differences in the expression of AKT and P-AKT before and after NACT Statistical significance, P <0.001. The count of LMVD in cervical squamous cell carcinoma before chemotherapy was 20.87 ± 3.31, and the count of LMVD in cervical squamous cell carcinoma after chemotherapy was 16.47 ± 3.44. The LMVD in cervical squamous cell carcinoma after chemotherapy was significantly lower (t = 6.32, P <0.001). Before chemotherapy, AKT positive for cervical squamous cell carcinoma was 21.14 ± 3.19, which was higher than that of negative group (17.00 ± 3.00). Spearman correlation analysis showed that the expression of LMVD before and after chemotherapy (r_s = 0.39, P = 0.007) was positively correlated with the expression of P-AKT before and after chemotherapy (r_s = 0.66, P <0.001). Chemotherapy after LMVD and AKT expression after chemotherapy was positively correlated, r_s = 0.58, P <0.001. Lymph node metastasis was positively correlated with LMVD before and after chemotherapy (r_s = 0.44, P <0.001; r_s = 0.36, P = 0.013). Lymph node metastases in patients with chemotherapy before chemotherapy LMVD were higher than those without lymph node metastasis. Conclusions The expression of P-AKT before chemotherapy and the expression of AKT and P-AKT after chemotherapy are positively correlated with lymphangiogenesis in tumor. The expression of P-AKT before chemotherapy is positively correlated with the metastasis of lymph node. Chemotherapy efficacy indicators.