大肠癌术前选择性动脉注化疗的临床病理观察

目的 研究术前选择性动脉灌注化疗对大肠癌的治疗作用。方法 应用氟尿嘧啶、表阿霉素和丝裂霉素对63例大肠癌病人术前进行选择性动脉插管化疗，并对其临床表现及病理结果进行了观察和对比。结果 （1）化疗后腹痛减轻有18例，腹胀缓解16例，便血减轻7例，在13例伴不全梗阻的患者中，有9例缓解；（2）化疗后病理变化有癌细胞出现核固缩、核碎裂、细胞浆凝固、坏死，细胞间质出现炎性细胞浸润、水肿、纤维增生，血管出现内膜增生和血栓形成，这些变化多以中度改变为主；而细胞浆坏死及血管内膜增生则呈重度改变。结论 术前选择性动脉注化疗可以控制原发灶及微小转移灶，缓解梗阻、便血等临床症状，从而有利于手术及改善术后生存率。

Pathological and clinical observation of preoperative selective arterial infusionchemotherapy of colorectal cancer

Objective To study the effect of preoperative selective arterial infusion chemotherapy (PSAIC) on large intestine cancer. Methods 63 patients with colorectal cancer underwent PSAIC with 5 fluorouracil,mitomycin and E adriamycin; the changes of clinical manifestation and pathology were observed and analyzed. Results (1)clinical manifestation:abdominalgia relieved in 18 patients and abdominal distention relieved in 16 patients.Improvement of hematochezia was found in 7 patients.In addition, of 13 patients with partial ileus, the clinical symptoms relieved in 9 patients. (2) pathology: there were karyopyknosis,karyorrhexis,coagulation and necrosis of cytoplasm in cancer cells. infiltration of inflammatory cells, edema and fibroelastosis in mesenchyne of cancer tissue. Proliferous intima and thrombus were also observed in the vessels. Most of these changes were moderate,and marked changes could also be seen in necrosis of cytoplasm and vessel intima proliferation. Conclusion PSAIC can control the focus of primary disease and the micrometastatic foci as well as improve the clinical symptoms, such as intestinal obstruction, and hematochezia, so PASIC is helpful to subsequent operation,and can improve the survival rate of patients with colorectal cancer.