直肠癌根治术中盆腔热灌注化疗的应用研究

目的研究不同温度的盆腔热灌注化疗对进展期大肠癌的疗效及其预防术后早期局部复发的作用。方法将施行根治性手术的直肠癌患者174例随机分成三组,单纯灌注组(低渗常温灌注,单灌组)、温化灌注组(低渗温热灌注化疗,温化组)、热化灌注组(低渗高热灌注化疗,热化组)。测定各组术前、术后血清中癌胚抗原(CEA)、血清糖蛋白(CA199)、恶性肿瘤特异生长因子(TSGF)的含量变化,盆腔灌注前后腹水CEA值的变化。结果单灌组与温热化疗组相比,单灌组术后三项血清监测指标升高均高于温热化疗组(P<0.01),热化疗组灌注后腹水CEA值较单灌组和温化灌注组明显下降(P<0.05),尤其与单灌组比较差异显著(P<0.01)。结论进展期直肠癌根治性术中行低渗盆腔热灌注化疗后可显著降低患者相关肿瘤指标,清除、杀灭术中脱落的肿瘤细胞,防止肿瘤早期局部复发,近期疗效肯定。

Exploratory Development of Intrapelvic Hyperthermic Chemoperfusion in Radical Resection of Rectal Cancer

Objective To observe the curative effect of different temperatures of intrapelvic hyperthermic chemoperfusion(IHCP)in progressive rectal cancer,and the prevention effect of IHCP in local recurrence at early stage.Methods 174 patients who were performed radical resection of rectal cancer were divided randomly into three groups(group Ⅰ=hypotension and common temperature perfusion,group Ⅱ=hypotension and lukewarm chemoperfusion,group Ⅲ=hypotension and hyperthermy chemoperfusion).The contents of CEA,CA199 and TSGF in the serum pre-operation and post-operation were detected.The contents of CEA in the ascites pre-IHCP and post-IHCP were observed.Results The contents of CEA,CA199 and TSGF in the serum of groupⅠ were significantly higher than them in group Ⅱ and group Ⅲ(P<0.01).The contents of CEA in the ascites post-IHCP of group Ⅲ were significant lower than them in groupⅠ(P<0.01)and group Ⅱ(P<0.05).Conclusion Clinical application of IHCP in radical correction of progressive rectal cancer should significantly depress correlation tumor index.IHCP can clear the shedding tumor cells in operation and depress local recurrence at early stage.