淋巴化疗对胃癌淋巴转移灶的临床治疗研究

目的研究淋巴化疗对胃癌淋巴转移灶的直接治疗作用.方法实验组(淋巴化疗组)术前经内镜胃粘膜下注射,加手术时胃浆膜下及腹膜内注射化疗药与活性碳的混悬液;对照组(血液化疗组)术前经股动脉插管灌注化疗药的水溶液,用流式细胞术检测化疗前后的胃癌组织及化疗后的转移淋巴结.结果淋巴化疗后,检测术后阳性淋巴结,其SPF(S期细胞比例)、APO(细胞凋亡)发生率及bcl-2表达与动脉灌注化疗组之间的差异有高度显著性(P＜0.01).结论经血液途径给药的化疗对淋巴系统转移灶作用甚微,而淋巴化疗能促进淋巴系统肿瘤细胞凋亡的发生,对淋巴转移灶具有直接的治疗作用.

Lymphatic Chemotherapy for Gastric Cancer with Metastatic Lymphatic Lesions

Objective:To study the direct therapeutic action of lymphatic chemotherapy a-gainst lymphatic metastasis of gastric cancer.Methods:Lymphatic chemothetrapy group:The chemotherapeutic agent was injected into the submucosa preoperatively via fiber-gastroscope plus subserosal and intraperitoneal injection of chemotherapeutic agent and suspension of activated car-bon during operation.Control group:Chemotherapeutic agent solution was injected via the catheterization of femoral artery preoperatively.The pre-and post-chemotherapy changes of gastric cancer tissues and post-chemotherapy lymphatic metastasis status were examined by flow cytome-try.Results:After lymphatic chemotherapy,examination of positive lymph nodes postoperatively showed that the incidence of SPF,APO and the difference between Bcl-2expression and arterial perfusion chemotherapy were significant (P<0.01).Conclusion:The lymphatic chemotherapy can promote the apoptosis of tumor cells in lymphatic system,while the action of blood chemotherapy for lymphatic metastasis is rather weak.