摘要
目的观察术前介入化疗对直肠癌的疗效及对细胞凋亡和细胞增殖的时相变化的影响。方法对１２例直肠癌患者术前应用Ｓｅｌｄｉｎｇｅｒ法经皮股动脉穿刺插管，选择肿瘤供血动脉一次性灌注化疗药物，５氟脲嘧啶６００ｍｇ／ｍ２，丝裂霉素Ｃ１５ｍｇ／ｍ２，阿霉素３５ｍｇ／ｍ２。分别于化疗前、化疗后２４、４８、７２小时和７～１０天取肿瘤组织，应用末端脱氧核苷酸转移酶（ＴｄＴ）介导的原位标记法（ＴＵＮＥＬ）检测凋亡细胞，应用免疫组化方法检测增殖细胞核抗原（ＰＣＮＡ）。结果术前介入治疗全身反应轻，临床缓解率为７５％。化疗后２４、４８、７２小时和７～１０天细胞凋亡指数分别为１９５３‰、１３１５‰、１１８５‰和１１８６‰，均显著高于介入治疗前的６８４‰；细胞增殖指数化疗前为４５５６％，化疗后分别为４０６８％、３９８７％、５１２８％和６３７５％，表现为化疗后第１、２天降低，第３天开始增高，第７～１０天较化疗前明显增加。结论直肠癌介入治疗可暂时改善局部症状，其机理可能是通过诱导癌细胞凋亡，而且这种诱导作用是一持续过程，在化疗后７～１０天仍然起作用。
Objective To investigate the timing changes of apoptosis (APO) and PCNA after intra arterial infusion chemotherapy for rectal cancer. Methods Twelve patients were subjected to percutaneous arterial femoralis catheterization by Seldinger′s technique and infusion of anti cancer drugs: 5 fluorouracil(5 Fu) 600 mg/m 2, mitomycin (MMC) C5 mg/m 2 and epirubicin(EDR)35 mg/m 2. The biopsy of rectal tumor tissues was done before chemotherapy,and 24, 48, 72 hours and 7 10 days after chemotherapy. Apoptotic cells were examined by terminal deoxynucleotidyl transferase(TdT) mediated dUTP fluorescein and labeling. The expression of proliferating cells nuclear antigen (PCNA) was detected by immunohistologic staining. Results The apoptosis index (AI) of rectal cancer cells beforechemotherapy, and 24 ,48,72 hours, and 7 10 days after chemotherapy was 6 84‰ ,19 53‰,13 15‰,11 85‰ and 11 86‰ respectively. The PCNA index (PI) was 45 56%,40 68%,39 87%,51 28% and 63 75% before and 24,48,72 hours, and 7 10 days after chemotherapy. Conclusions Intra arterial infusion chemotherapy not only induced apoptosis effectively, but also inhibited temporarily tumor cells proliferation in patients. The curative surgical treatment should be performed as soon as possible after chemotherapy.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1999年第4期225-227,共3页
Chinese Journal of Surgery
