紫杉醇脂质体注射液初始化疗后非小细胞肺癌组织病理学变化

目的探讨紫杉醇脂质体注射液初始化疗后非小细胞肺癌组织病理学变化。方法选取40例临床诊断为非小细胞肺癌IIIB患者,随机分为2组,每组各20例。对照组:立即行手术治疗。试验组:术前1个月应用紫杉醇脂质体注射液初始化疗后手术;应用HE染色、电镜方法分别观察2组患者病理学改变。结果(1)2组病理学疗效评价:试验组I、II级共13例,明显高于对照组的0例,而III、IV级分别为3例、4例,明显少于对照组的6例、14例,疗效评价差异有统计学意义(P<0.05);试验组较对照组瘤细胞坏死明显,细胞空泡变性增多,核固缩、凝固性坏死显著。肿瘤组织及其周围组织中可见大量淋巴细胞和嗜酸性细胞浸润;(2)2组生存质量、T细胞亚群变化及其不良反应差异均无统计学意义(P>0.05)。(3)患者临床疗效与年龄、性别之间无相关性(r=0.284,P>0.05),与肿瘤类型密切相关(P<0.05)。结论IIIB期非小细胞肺癌患者应用紫杉醇脂质体注射液初始化疗后,可获得较好的组织病理学疗效评价。

The histopathological changes of non-small cell lung cancer treated with paclitaxel liposome injection as primarily chemotherapy

Objective To analyze the histopathological features of non-small cell lung cancer treatment with paclitaxel liposome injection as primarily chemotherapy. Methods Consecutive selected 40 cases with non-small cell lung cancer at grade ⅢB , were divided into control group and treatment group randomly. The surgery was executed immediately in control group, while the paclitaxel liposome injection was administrated as primarily chemotherapy for 1 month in treatment group. The pathological analysis were compared between two groups, with HE staining and electron microscope methods. Results （ 1 ） There were 13 cases with grade Ⅰ,Ⅱ and 3,4 cases with grade Ⅲ, Ⅳ non-small cell lung cancer in treatment group,while there were 0 cases with grade Ⅰ,Ⅱand 6, 14 cases with grade Ⅲ, Ⅳ. The therapeutic effect showed statistical significant difference between two groups （ P 〈 0.05 ）. In addition, the necrosis of tumor cells was obvious in treatment, and improving cellular vacuolar degeneration, pyknosis and coagulation necrosis was obvious too. There was large amount of lymphocytes and acidophilic cellular infihration around tumor tissue. （ 2 ） The survival ratio, T cell subtype ratio and side effect between two groups had no difference （ P 〉 0.05 ）. （ 3 ） The therapeutic effect bad no relationship with the patients＇gender and age （ r =0.284, P 〉0.05） ,while had closely correlation with type of the tumor （ P 〈 0.05 ）. Conclusion It could inhibit tumor growth by primary chemothera py with paclitaxd liposome, and it worthy to applying in clinical treatment.