应用叶酸和维生素B12治疗肺癌癌前病变的观察

一般认为支气管粘膜上皮非典型增生是肺癌的癌前病变。此研究通过应用叶酸和维生素B12治疗吸烟者的支气管粘膜上皮非典型增生达到化学预防肺癌的目的。研究对象为经纤支镜活检诊断的30例支气管粘膜上皮非典型增生病人。治疗组17例（27个病灶），对照组13例（18个病灶）。治疗组每日口服叶酸10mg和维生素B12750μg，3个月。组织学异型程度用0～4的等级判定。结果表明，治疗组在治疗前组织异型程度平均为1．6，治疗后为0．3，两者比较有显著性差异（P＜0．01）．对照组前后变化不明显，分别为1．3和1．1。测定血中叶酸和维生素B12浓度，在治疗组维持较高的浓度。作者认为叶酸和维生素B12有治疗肺癌癌前病变支气管粘膜非典型增生的作用。

Role of Folio Acid and Vitamin B_(12) in the Treatment of Precancerous Lesions of Bronchial Atypical Hyperplasia

The purpose of this study is to treat bronchial atypical hyperplasia,known as precancerous lesions in heavy smokers with folio acid and vi tamin B12.The bronchial lesions were identified by bronchofiberscopy in all cases.The grade of cellular atypia was measured on the histological specimens using a scoring system from 0 to 4.Thirty patients with atypical hyperplasia,including 17 patients taking folio acid and vitamin B12 and 13 patients without medicine were in vestigated prospectively for three months.There were no significant differences on the scores at the beginning in the trial group(1.6)and control group(1.3).The tri al group showed significant decrease of the scores(0.3)while the control did not (1.1).The plasma level of folio acid and vitamin B12 in the trial group significantly increased at the end,while that in the control group decrease slightly.The results showed that bronchial atypical hyperplasia in heavy smokers might be treated with folic acid and vitamin B12.