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目的探讨直肠癌新辅助化疗对凋亡相关基因bcl-2、bax的影响。方法对43例局部进展期直肠癌患者,术前通过结肠镜活检证实为直肠癌,采用免疫组化SP法检测bcl-2、bax蛋白的表达,脱氧核糖核苷酸末端转移酶介导的缺口末端标记技术(TUNEL)检测直肠癌细胞的凋亡指数。新辅助化疗NCT采用FOLFOX-4两天方案,每2周重复1次,28天为1个化疗周期,完成2个周期进行临床疗效评价后行手术治疗,术后标本应用免疫组化SP法、TUNEL技术观察bcl-2、bax蛋白和AI的变化。结果化疗后直肠癌组织中bcl-2、bax阳性细胞率和细胞凋亡指数分别为(43.29±7.42)%、(72.9±9.18)%和(10.79±3.05)%,与化疗前(65.7±8.53)%、(54.8±7.86)%和(5.38±2.24)%相比较差异有统计学意义(P<0.01);化疗后部分缓解(PR)病例bcl-2、bax阳性细胞率与无效(NC)病例相比较差异有统计学意义(P<0.01)。结论新辅助化疗可明显促进直肠癌细胞的凋亡。而且这两种基因的表达水平与新辅助化疗疗效具有显著的相关性;而且这两种基因的表达水平有可能成为进展期直肠癌化疗疗效的预测指标。
Objective To investigate the effect of neoadjuvant chemotherapy on apoptosis-related genes bcl-2 and bax in rectal cancer. Methods Forty-three patients with locally advanced rectal cancer were examined by colon biopsy before operation. The expression of bcl-2 and bax protein was detected by immunohistochemical SP method and the expression of bcl-2 and bax The apoptosis index of rectal cancer cells was detected by TUNEL. Neoadjuvant chemotherapy NCT with FOLFOX-4 two-day program, repeated once every two weeks, 28 days for a chemotherapy cycle, completed two cycles of clinical efficacy evaluation after surgery, postoperative specimens using immunohistochemical SP method, TUNEL technique was used to observe the changes of bcl-2, bax protein and AI. Results The positive rates of bcl-2, bax and apoptotic index in rectal cancer tissues after chemotherapy were (43.29 ± 7.42)%, (72.9 ± 9.18)% and (10.79 ± 3.05)%, respectively, ), (54.8 ± 7.86)% and (5.38 ± 2.24)%, respectively (P <0.01). After chemotherapy, the rates of bcl-2 / The difference was statistically significant (P <0.01). Conclusion Neoadjuvant chemotherapy can significantly promote the apoptosis of rectal cancer cells. Moreover, the expression levels of these two genes are significantly correlated with the efficacy of neoadjuvant chemotherapy. Moreover, the expression levels of these two genes may be predictors of the efficacy of chemotherapy in advanced rectal cancer.