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

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.

Keywords: Cervical cancer; neoadjuvant chemotherapy; prognostic factors; radical laparoscopic surgery; survival.

Figure 1

Changes in tumor markers before and after treatment. A. Changes in the expression level of SCC-Ag before and after treatment. B. Changes in the expression level of CEA before and after treatment. C. Changes in the expression level of CA125 before and after treatment. Note: SCC-Ag, squamous cell carcinoma antigen; CEA, carcinoembryonic antigen; CA125, serum glycan antigen 125; ns P > 0.05, ****P < 0.0001.

Figure 2

Changes in tumor markers before and after treatment. A. Changes in E2 level before and after treatment. B. Changes in FSH level before and after treatment. C. Changes in LH level before and after treatment. Note: E2, estrogen; FSH, follicle-stimulating hormone; LH, luteinizing hormone; ns P > 0.05, ****P < 0.0001.

Figure 3

Correlation analysis of sex hormone-related indexes with tumor markers. A. Correlation analysis of E2 with tumor markers SCC-Ag, CEA, and CA125. B. Correlation analysis of FSH with tumor markers SCC-Ag, CEA, and CA125. C. Correlation analysis of LH with tumor markers SCC-Ag, CEA, and CA125. Note: SCC-Ag, squamous cell carcinoma antigen; CEA, carcinoembryonic antigen; CA125, serum glycan antigen 125; E2, estrogen; FSH, follicle-stimulating hormone; LH, luteinizing hormone.

Figure 4

K-M survival curve of patient clustered by different prognostic factors. A. Survival curves of patients in the high and low E2 expression groups. B. Survival curve of patients in the high and low LH expression groups. C. Survival curve of patients in the high and low SCC-Ag expression groups. Note: SCC-Ag, squamous cell carcinoma antigen; E2, estrogen; LH, luteinizing hormone.