摘要
目的 观察大肠癌术前经动脉导管化疗对大肠癌组织学疗效和细胞凋亡的影响。方法 5 0例大肠癌术前经导管联合抗癌药物灌注治疗 ,介入化疗后 5～ 30d(平均 12d)外科手术切除肿瘤。切除标本作组织学疗效观察和细胞凋亡测定 ,其中介入治疗前 2 2例肠镜活检标本和 2 5例正常肠黏膜 (标本正常肠切缘 )作对照。结果 肿瘤组织学疗效Ⅰ级 2 0例 ,Ⅱ级 2 1例 ,Ⅲ级 9例。肿瘤凋亡细胞密度介入化疗前为 (31 4 7± 5 5 8)个 /网格 ,介入化疗后为 (76 6 9± 17 12 )个 /网格 ,正常肠黏膜为 (8 0 1± 3 39)个 /网格。凋亡细胞密度介入治疗后明显高于介入治疗前 (t =13.70 1,P <0 0 0 1) ,腺癌明显高于正常肠黏膜 (t=5 0 .978,P <0 0 0 1)。 5 0例中 5例失访 ,4 5例获得随访结果 ,1、3和 5年生存率分别为 95 1%、71 1%和 4 8 5 %。不同病理分期的组织学疗效之间差异无显著性意义 (χ2 =4 .6 96 ,P >0 30 )。组织学化疗反应和肿瘤细胞凋亡之间呈正相关 (F =7.73,P <0 0 1)。不同分化程度肿瘤的细胞凋亡比较差异无显著性意义 (t=0 .392 7,P >0 0 5 )。不同病理分期肿瘤的细胞凋亡比较差异也无显著性意义 (t=0 .0 0 1376 ,P >0 0 5 )。结论 大肠癌术前经导管动脉灌注化疗 ,肿瘤组织学疗效显著 。
Objective To investigate apoptosis and histological response of preoperative intraarterial chemotherapy infusion for colorectal carcinoma. Methods Fifty patients with colorectal carcinoma were treated by intraarterial infusion of anti-cancer drugs. Surgical resection of the tumor was performed 5- 30 days after the intraarterial infusion (mean 12 days). The histological response was evaluated. The density and distribution of the apoptosis cells were observed by DNA nick end labelling technique. 22 biopsy specimens before the intraarterial chemotherapy and 25 normal mucosa (obtained from surgery specimen) were used as controls.Results The total histological response rate was 100% with grade Ⅰ in 20 cases, grade Ⅱ in 21 cases, and grade Ⅲ in 9 cases. The density of the apoptosis cells was 31.47±5.58 before and 76.69±17.12 after the intraarterial chemotherapy infusion, and 8.01±3.39 in normal mucosa, respectively. The density of the apoptosis cells after the intraarterial chemotherapy was significantly higher than that before the intraarterial chemotherapy(t=13.701, P<0.001), while the density of the apoptosis cells in adenocarcinoma was significantly higher than that in normal mucosa(t=50,978,P<0.001). The 1-, 3-, and 5-year survival rate was 95.1%, 71.1%, and 48.5%, respectively. The histological response in different pathological stages was not significantly different (χ2=4.696,P>0.30). The apoptosis of adenocarcinoma was significantly different with different histological response (F=7.73,P<0.01). There were no significant differences in the apoptosis for different differentiated adenocarcinomas(t=0.392 7,P>0.05) and for adenocarcinoma with different pathological stages(F=0.001 376,P>0.05).Conclusion As an effective and safe procedure, preoperative transcatheter intraarterial chemotherapy infusion achieves a significant histological response and apoptosis in colorectal adenocarcinoma.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2003年第12期1074-1077,共4页
Chinese Journal of Radiology
关键词
经动脉导管化疗
大肠癌
组织学
细胞凋亡
抗癌药物
联合治疗
Colorectal neoplasms
Radiology, interventional
Drug therapy, combination
Histology, comparative
Treatment outcome
