术前腹腔动脉灌注化疗对中晚期胃癌细胞凋亡和增殖的影响

目的 探讨术前腹腔动脉灌注化疗对中晚期胃癌细胞凋亡和增殖的影响。方法 采用切口末端标记法(TUNEL)、增殖细胞核抗原(PC-NA)和凋亡抑制蛋白(Bcl-2)免疫组化检测技术,观察比较术前腹腔动脉灌注化疗组31例和未化疗手术组32例中晚期胃癌标本的凋亡指数、增殖指数和BCcL-2蛋白表达强度的差异。结果 术前化疗组凋亡指数明显高于对照组(P<0.01),增殖指数明显降低(P<0.01),Bcl-2蛋白表达强度明显低于对照组(P<0.01)。凋亡指数与Bcl-2分值是显著负相关(P<0.01),凋亡指数与增殖指数呈中度正相关(P<0.05)。治疗组治愈性切除率明显高于对照组(P<0.01),3年生存率高于对照组(P<0.05)。结论 术前腹腔动脉插管化疗可诱导中晚期胃癌细胞凋亡,降低肿瘤细胞的增殖活力,提高治愈性切除率,改善患者生存率。诱导胃癌细胞凋亡可能与化疗药物降低Bcl-2基因蛋白的表达有关。

Effects of preoperative chemotherapy (intra-arterial infusion) on apoptosis and cellular proliferation of advanced gastric cancer

Objective To observe the effects of preoperative chemotherapy on apoptosis and cellular proliferation on gastric cancer in advanced stage, and to evaluate the significance of the effectiveness being taken as a prognostic marker. Methods TUNEL and immunohistochemical method were applied to detect the difference of AI, Bcl-2 and PCNA indices in 63 cases with gastric cancer in advanced stage. Thirty one cases treated by preoperative chemotherapy and other 32 cases without preoperative therapy as control. Results The apoptosis index (AI) in the group treated by preoperative chemotherapy was higher than that in control group (P<0. 01), but the proliferation index (PI) and the value of Bcl-2 protin were lower than that in control group (P< 0. 01). Negative correlation existed between AI and Bcl-2 protin. The level of expression in the treated group was detected by degree relative analysis (rs = -0. 743,P<0. 01). The three years survival rate in treated group was higher than that in control group (P<0. 05). Conclusions The application of preoperative chemotherapy for gastric cancer patient may decrease Bcl-2 protein expression and induce cancer cells apoptosis of gastric cancer cells. Preoperative chemotherapy is benefit for improving the survival rate of the patients.