化疗对肾母细胞瘤细胞凋亡及坏死的影响

目的 了解化疗对肾母细胞瘤细胞凋亡和坏死的影响。方法 对４４例肾母细胞瘤进行随机分组,Ａ组２６例,给予ＶＡＣ术前化疗,其中８例尚加用了介入化疗,Ｂ组１８例,Ｉ期手术治疗。用ＴＵＮＥＬ技术和常规病理检查观察了全部标本的凋亡和坏死情况,并分组进行了比较。结果 术前化疗后Ａ组瘤体凋亡指数（ＡＩ）较Ｂ组明显增加;Ａ组中化疗时间超过两周的病例ＡＩ较不足两周病例也有明显上升;但死亡和获两年以上生存病例,介入和

Influence of chemotherapy on apoptosis and necrosis of Wilms' tumor cells

Objective The aim of study is to investigate the influence of chemotherapy on apoptosis and necrosis in Wilms' tumor. Methods From 1990 to 1998, 44 children with Wilms' tumor were randomized into two groups. Group A ( n =26) underwent preoperative chemotherapy with Dacinomycine, Vincrinstine and Cyclophosphamide. Eight of them had additional chemo-embolization with iodized oil and Adramycin via renal artery. Group B ( n =18) underwent nephrectomy followed by chemotherapy. Utilizing the technique of TUNEL and routine pathological methods, the status of apoptosis and necrosis were determined in all specimens. Results The Apoptotic Index (AI) of group A was significantly higher than that of group B ( P < 0.05 ). Within group-A patients, AIs of those who had more than 14 days of chemotherapy were higher than the AI of those less than 14 days. The AIs between those who died and those who survived for two or more years, between those who had additional chemo-embolization and those who did not, between those diagnosed as FH and as UH, were not statistically significant. The difference in rates of complete tumor necrosis were statistically significant between group A and group B patients ( P < 0.05 ). The difference between those who had additional chemo-embolization and those who had not was also statistically significant ( P < 0.05 ). Conclusions Chemotherapy can produce significant apoptosis and necrosis in Wilms' tumors. Preoperative chemotherapy and additional chemo-embolization can lead to more necrosis. AI of Wilms' tumor may not be as a prognostic factor but can be used as an indicator of the efficacy of chemotherapy.