Improvement of Long Term Survival for Malignant Ovarian Tumor

PVB方案对卵巢癌的疗效上级优于CAP方案（p<0.05）。两组患者的生存率差异在24个月内逐渐增大，但此后生存率以相同的速度逐渐下降。两种方案的无病生存率无显著差异。提示手术和化疗是提高卵巢癌生存率的重要手段。150例交界性恶性肿瘤病例也进行了分析。I期125例，保守治疗52例。I期患者术后虽未接受辅助治疗，但无死亡病例，提示I期患者辅助治疗意义不大。另一方面，25例II期或以上患者中有9例死亡。因此，包括顺铂在内的辅助化疗可用于晚期病例。然而，辅助化疗对粘液性交界性病例和粘液性癌无效。MMPs和TIMPs在肿瘤细胞的侵袭和转移中起着重要的作用。应用明胶酶谱法和反向酶谱法检测了妇科癌组织中这些蛋白质的表达。MMP-9在癌组织中的表达明显高于正常组织，尤其是在癌组织中的表达明显增加，而正常组织中MMP-9的表达量很少。TIMP-1在癌组织中的表达明显高于正常组织。此外，我们还检测了腹膜、子宫肌层和卵巢中的这些蛋白。MMP-9主要分泌于腹膜，TIMP-1主要分泌于卵巢。这些正常组织的条件培养基具有诱导卵巢癌细胞产生MMPs和TIMPs的能力。这些结果表明，正常组织对癌细胞的影响与癌细胞的侵袭密切相关。

PVB regimen was superior to CAP regimen for ovarian cancer (p<0.05). Although difference of survival rate increased between 2 regimems within 24 months, thereafter survival rates decreased gradually at the same rate. Furthermore, there were no difference observed between 2 regimen in disease free survival. These results suggested that primary treatment including operation and chemotherapy was very important to improve survival for ovarian cancer. One hundred and fifty borderline malignancy cases were also analyzed. One hundred and twenty-five cases were stage I and 52 cases were managed conservely pregnancy potencial. Although stage I cases received no adjuvant therapy after operation, no cases died, suggesting that adjuvant therapy was meanless in stage I cases. On the other hand, 9 cases died among 25 with stage II or more. Thus, adjuvant chemotherapy including cisplatin might be performed in advanced cases. However, adjuvant chemotherapy would not be effective on mucinous borderline cases as well as mucinous cancer. MMPs and TIMPs have been focused for cancer cell invasion and metastasis. These proteins were examined in gynecologic cancer tissues by using gelatin zymography and reverse zymography. The secretion of MMPs increased more in cancer tissues than that in normal tissues and specially MMP-9 increased remarkably in cancer tissues, although this enzyme was secreted little in normal tissues. The secretion fo TIMP-1 increased more in cancer tissues than that in normal tissues. Furthermore, we examined these proteins in peritoneum, myometrium and ovary. MMP-9 was secreted mostly in peritoneum and TIMP-1 in ovary. Conditioned medium of these normal tissues had the potency to induce MMPs and TIMPs from ovarian cancer cells. These results suggested that the influence of normal tissues on cancer cells was strongly associated with cancer cells invasion.