化疗联合腹腔灌注治疗直肠癌恶性腹水的临床观察

目的 评价化疗联合顺铂腹腔灌注治疗直肠癌恶性腹水的疗效以及腹水癌细胞凋亡和Trail的表达情况.方法 将2010年1月至2012年12月福建医科大学附属协和医院收治的伴有恶性腹水的83例晚期直肠癌患者,随机分为单纯化疗组（37例,伊立替康＋5-氟尿嘧啶的FOLFIRI方案）和综合治疗组（46例,FOLFIRI方案化疗十顺铂腹腔灌注）,比较两组患者临床疗效、腹腔积液中癌细胞凋亡和Trail的表达.结果 与单纯化疗组相比,综合治疗组患者腹水明显减少,腹水控制率DCR更高（80.43％比72.97％.P＜0.05）.与腹腔灌注前比较,腹腔灌注后,Trail表达和癌细胞凋亡增加（P＜0.05）.结论 与单纯化疗相比,综合治疗组对直肠癌腹水患者取得更好疗效,同时促进癌细胞凋亡.

Clinical observation of chemotherapy combined with intraperitoneal treatment of malignant ascites in colorectal cancer

Objective：To evaluate the efficacy of chemotherapy combined with intraperitoneal perfusion for colorectal cancer patients with ascite and the expression of Trail.Methods：From January 2010 to December 2012,83 advanced colorectal cancer patients with malignant ascites in Union Hospital of Fujian Medical University were enrolled in the study.Patients were randomly divided into 2 groups：FOLFIRI chemotherapy alone （Irinotecan and 5-fluorouracil） was applied in 37 patients （chemotherapy group） and FOLFIRI combined with intraperitoneal perfusion of cisplatin in 46 patients （combination group）.The efficacy,apoptosis in ascites and the expression of Trail were compared between the two groups.Results：Compared with the chemotherapy group,the combination group had a less volume of peritoneal fluid drainage and higher disease control rate （80.43％ vs.72.97％,P ＜0.05）.The number of apoptotic cells and the expression of Trail were better after intraperitoneal perfusion （P ＜0.05）.Conclusion Compared with chemotherapy alone,chemotherapy combined with intraperitoneal perfusion in colorectal cancer patients with malignant ascites possesses better efficacy,while promoting apoptosis.