Exploration of clinical,histopathological and electron microscopic changes of cervical cancer following neoadjuvant chemotherapy and its mechanism

Objective To explore the clinical,histopatholoical and electron microscopic response to the neoadjuvant chemotherapy(NACT) for the patients with cervical cancer and to investigate the mechanism of the effect.Methods Cisplatin-based NACT was given to twenty-four patients with cervical cancer stage ⅠB-ⅡB.Two weeks later,they received radical hysterectomy.Clinical response was observed,and histopathologic and electron microscopic changes from pre-chemotherapy core biopsies to post-chemotherapy surgical specimens were examined and analyzed.The expression of p53 was examined immunohistochemically.Results After NACT,the total clinical response rate (PR) was 66.7 %(16/24),the histopathologic improvement of Ⅱor Ⅲ grades in 13 cases(54.2 %).The subcellular responses under electron microscope were the broadened distance among cancer cells,poor structure of desmosome,swelling of mitochondria and endoplasmic reticulum,lightening of nuclear groundsubstance and caryolysis,and the chromosomes becoming highly dense body.The expression of p53 increased.Conclusions NACT shrinks the tumor's bulk before operation,gives the opportunity to remove the tumor completely.The cancer cells reveal degeneration,necrosis and apoptosis,and the possible mechanism is NACT induces p53-independent apoptosis.NACT is an effectively preoperative therapy for cervical cancer.