论文部分内容阅读
目的 评价术前介入化疗和手术对大肠癌的治疗价值。方法 66例大肠癌术前经导管动脉内联合抗癌药物灌注治疗,治疗后5～30d(平均12d)手术切除肿瘤。其中50例切除标本作了组织学疗效和细胞凋亡观察,以介入治疗前22例肠镜活检标本和25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20例,Ⅱ级21例,Ⅲ级9例。肿瘤凋亡细胞密度介入化疗前为31.47±5.58,介入化疗后为76.69±17.12,正常肠黏膜为8.01±3.39。介入治疗后凋亡细胞密度明显高于介入治疗前(P<0.001),腺癌明显高于正常肠黏膜(P<0.001)。不同病理分期肿瘤的组织学疗效之间差异无显著性(P>0.30)。不同病理分期肿瘤的细胞凋亡也无差异(P>0.05)。1、3和5年生存率分别为95.1％、71.1％和48.5％。介入治疗后66例中手术根治58例,根治率为87.9％。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,肿瘤细胞凋亡明显。
Objective To evaluate the value of preoperative interventional chemotherapy and surgery in the treatment of colorectal cancer. Methods Sixty-six patients with colorectal cancer were treated with intra-catheter and intra-arterial infusion of anticancer drugs before operation, and the tumors were resected 5 to 30 days after operation (mean 12 days). Fifty cases of resected specimens were observed for histological efficacy and apoptosis. Twenty-two colonoscopy biopsy specimens and 25 normal intestinal mucosa (normal intestinal margin) were used as control before interventional treatment. Results Tumor histological grade Ⅰ in 20 cases, Ⅱ grade in 21 cases, Ⅲ grade in 9 cases. The apoptotic cell density before intervention was 31.47 ± 5.58, after interventional chemotherapy was 76.69 ± 17.12, and that of normal intestinal mucosa was 8.01 ± 3.39. After intervention, the density of apoptotic cells was significantly higher than that before intervention (P <0.001), and adenocarcinoma was significantly higher than that of normal intestinal mucosa (P <0.001). There was no significant difference in the histological efficacy between different pathological stages (P> 0.30). There was no difference in apoptosis between different pathological stages (P> 0.05). 1,3 and 5-year survival rates were 95.1%, 71.1% and 48.5%. Among the 66 cases after interventional therapy, 58 cases were cured by radical operation, the cure rate was 87.9%. Conclusion Colorectal cancer preoperative transcatheter arterial infusion chemotherapy, tumor histology significant effect, tumor cell apoptosis was obvious.