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目的 :探讨电化学治疗中晚期宫颈癌的临床疗效 ,分析影响其疗效的临床病理相关因素以及探讨电化学治疗中晚期宫颈癌的可能机制。方法 :对 114例临床分期为 b 期以上的中晚期宫颈癌采用电化学加放射治疗 (电化学治疗组 )并与同期采用单纯放射治疗的 6 8例期别相同的中晚期宫颈癌 (单纯放疗组 )进行中远期疗效对比分析。分别采用苏木桂 -伊红染色、流式细胞仪、组织 DNA电泳、透射电镜、TUNNEL 末端标记、酶免和免疫组化技术对其中采用电化学加放射治疗的 2 0例患者进行治疗前后的局部病灶组织病理改变、细胞凋亡、癌基因和抑癌基因改变以及机体免疫状况的测定和对比分析。结果 :1电化学治疗组患者 3,5年生存率明显高于单纯放疗组 (P <0 .0 5 ) ,但 1年生存率两组无明显差异 (P >0 .0 5 ) ;2临床期别早、肿瘤直径小及病灶呈菜花型患者电化学治疗后远期疗效较好 (P <0 .0 5 )。但疗效与肿瘤的病理类型和分化级别无关 (P >0 .0 5 ) ;3治疗剂量以 15 0 C/1cm肿瘤直径计算 ,2次或以上的治疗其远期疗效较好 ;4电化学治疗组的复发率低于单纯放疗组 (P <0 .0 5 ) ;5电化学治疗局部病理形态改变 ,阳极以凝固性坏死为主 ,阴极以液化性坏死为主。在其病灶均有大量淋巴细胞浸润 ;6电化学治疗后患者外周血中 T3、T4 ?
Objective: To investigate the clinical efficacy of electrochemical treatment of advanced cervical cancer, analyze the clinical and pathological factors affecting its efficacy and explore the possible mechanism of electrochemical treatment of advanced cervical cancer. Methods: One hundred and eleven patients with advanced stage cervical cancer with stage b or more were treated with electrochemotherapy plus radiotherapy (electrochemotherapy group) and were treated with radiotherapy alone (68 cases) with advanced stage cervical cancer (radiotherapy alone) Group) in the long-term comparative analysis of efficacy. Twenty-one patients were treated with electrochemiluminescence and radioimmunoassay before and after treatment with somatogenin-eosin staining, flow cytometry, tissue DNA electrophoresis, transmission electron microscopy, TUNEL labeling, enzyme immunoassay and immunohistochemistry respectively Histopathological changes, apoptosis, changes in oncogenes and tumor suppressor genes and immune status of the determination and comparative analysis. Results: The 3-year and 5-year survival rates of the patients in the electrochemical therapy group were significantly higher than those in the radiotherapy alone group (P <0.05), but there was no significant difference in the 1-year survival rate between the two groups (P> 0.05) The earlier period, the smaller the diameter of the tumor and the cauliflower-type patients had better long-term curative effect after electro-chemical therapy (P <0.05). However, the curative effect was not related to the pathological type and differentiation grade of the tumor (P> 0.05); 3 The treatment dose was calculated at 15 0 C / 1cm tumor diameter, and the long-term curative effect was better after 2 or more treatments. 4 Electrochemical therapy Group recurrence rate was lower than the radiotherapy alone group (P <0 05); 5 electrochemical treatment of local pathological changes, the main anode coagulation necrosis, the main cathode liquefaction necrosis. In its lesions have a large number of lymphocytic infiltration; 6 after chemotherapy in patients with peripheral blood T3, T4?