热化疗对恶性胸腔积液中肿瘤细胞表达Ｋｉ-６７、ＰＣＮＡ、Ｂｃｌ-２、ｐ５３的影响

目的　研究射频热疗联合胸腔灌注化疗对恶性胸腔积液中肿瘤细胞表达Ｋｉ-６７、ＰＣＮＡ、Ｂｃｌ-２和ｐ５３的影响。方法　８５例确诊为恶性胸腔积液患者随机分为热化疗组和灌注化疗组，采用中心静脉导管胸腔闭式引流，尽可能排尽胸水后，热化疗组４４例，给予顺铂胸腔灌注化疗，然后进行胸腔射频热疗；灌注化疗组４１例，仅予顺铂胸腔灌注化疗。通过免疫组化法检测治疗前和治疗１疗程后胸腔积液中肿瘤细胞Ｋｉ-６７、ＰＣＮＡ、Ｂｃｌ-２和ｐ５３的表达情况。结果　热化疗组治疗后胸腔积液中肿瘤细胞中Ｋｉ-６７和ＰＣＮＡ的表达率均较治疗前下降，两者比较均有统计学意义（Ｐ＜０.０５）；两组治疗后Ｋｉ-６７、ＰＣＮＡ、ｐ５３和Ｂｃｌ-２的表达率比较均无显著差异（Ｐ＞０.０５）。结论　射频热疗能够显著提高化疗抑制恶性胸腔积液中肿瘤细胞增殖和促进肿瘤细胞凋亡的作用。

Effects of thermochemotherapy on expressions of Ki-67, PCNA, Bcl-2 and p53 of tumor cells in malignant pleural effusion

Objective To study the influence on Ki-67,PCNA,Bcl-2 and p53 expression in the malignant pleural effusion with radiofrequency hyperthermia combined with intrapleural injection.Methods Eighty-five patients with malignant pleural effusion were randomly divided into two groups.Treatment group（44 cases）were treated with cisplatin（DDP） intrapleural injection and radiofrequency hyperthermia.Control group（41 cases）were treated with DDP intrapleural injection only.Before and after therapy the expression of Ki-67,PCNA,Bcl-2 and p53 of tumor cells were compared.Results In the treatment group,the expression rate of Ki-67 and PCNA decreased;the difference of them before and after therapy was significant（P0.05）.After therapy,the expression rates of Ki-67,PCNA,Bcl-2 and p53 between the two groups were no significance（P0.05）.Conclusion Radiofrequency hyperthermia can inhibit proliferation and promote apoptosis of tumor cells by chemotherapy.