Abstract:
Objective To investigate the administration of neoadjuvant chemotherapy (NACT) for controlling pelvic node metastasis by inducing tumor cell apoptosis in patients with cervical cancer.
Methods Immunohistochemical SP staining and in situ terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) were employed to assay the pelvic lymph node apoptotic status in 104 patients with cervical cancer, i.e., 54 NACT cases with stage IB and IIB cervical cancer awaiting surgery and 50 cases with stage IB and IA cervical cancer who have undergone immediate surgery. Among these cases, 54 (27 treated with NACT before surgery and 27 who underwent immediate surgery) were assessed for the apoptotic status of the in situ diseased regions simultaneously.
Results The total response rate of the chemotherapy to NACT was 74.07% in the 54 cases (40/54), with a lower incidence of pelvic node involvement (11/54, 20.37%) than the immediate surgery group (20/50, 40%). Both pelvic nodes and in situ diseased regions in the NACT group had a much higher caspase-3 expression and apoptotic index (AI) (P < 0.05) than those in the control or immediate surgery group. Additionally, the AI value in the pelvic nodes was significantly correlated with that in the in situ lesions (r=0.316, P=0.01).
Conclusion NACT is efficient in controlling pelvic node metastasis by inducing tumor cell apoptosis in patients with regionally advanced cervical cancer.