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目的探讨术前区域射频热疗同步靶动脉热灌注化疗对胃癌淋巴结转移灶癌细胞凋亡的影响。方法对40例胃癌伴淋巴结转移患者行胃癌根治性切除术,根据术前是否行区域射频热疗同步靶动脉热灌注化疗分为治疗组和对照组,每组20例,采用免疫组化ABC法检测淋巴转移灶p53、bcl-2及CD95基因的表达,应用原位末端脱氧核苷转移酶标记法(TUNEL)检测细胞凋亡情况。结果治疗组淋巴转移灶p53和CD95表达较对照组明显增强,差异有统计学意义(P<0.05),并与细胞凋亡呈正相关;bcl-2表达则减低,差异有统计学意义(P<0.05),与细胞凋亡呈负相关。结论胃癌术前行区域射频热疗同步靶动脉热灌注化疗,可能通过p53、bcl-2及CD95介导使转移淋巴结癌细胞凋亡增加,有助于提高根治性手术的疗效。
Objective To investigate the effect of preoperative regional radiofrequency thermotherapy with synchronous targeted arterial infusion chemotherapy on the apoptosis of lymph node metastasis of gastric cancer. Methods Forty patients with gastric cancer with lymph node metastasis undergoing radical resection of gastric cancer were divided into treatment group and control group according to whether the regional radiofrequency thermotherapy with synchronous target artery hot perfusion chemotherapy was performed preoperatively. Twenty patients in each group were treated with immunohistochemical ABC method The expression of p53, bcl-2 and CD95 genes in lymphatic metastasis was detected. TUNEL was used to detect the apoptosis. Results The expression of p53 and CD95 in lymphatic metastasis of the treatment group was significantly higher than that of the control group (P <0.05), and there was a positive correlation between the expression of p53 and CD95 and the apoptosis of the lymphoid metastasis group. The expression of bcl-2 was decreased, the difference was statistically significant (P < 0.05), but negatively correlated with apoptosis. Conclusions Regional radiofrequency thermochemotherapy with synchronous targeted arterial thermochemoerthy in preoperative gastric cancer may increase the apoptosis of metastatic lymph node cells by p53, bcl-2 and CD95, which may be helpful to improve the curative effect of radical surgery.