术前动脉化疗对胃癌细胞凋亡及p53表达的影响

背景与目的:区域化疗具有肿瘤局部药物浓度高、全身副作用小的特点,术前选择性区域动脉灌注化疗可明显改变胃癌患者的肿瘤组织学形态。本文旨在研究术前动脉化疗对胃癌细胞凋亡及p53表达的影响和意义。方法:对33例胃癌患者动脉化疗前胃镜活检病理标本和动脉化疗后手术切除的病理标本,应用DNA原位末端标记法、免疫组化S-P法分别检测肿瘤细胞凋亡及p53蛋白表达。结果:胃癌动脉化疗后肿瘤细胞凋亡指数为19.29±6.48,显著高于动脉化疗前的9.24±5.03(P<0.01);动脉化疗后p53表达阳性率为30.30%,显著低于动脉化疗前的54.55%(P<0.05);动脉化疗后p53表达“下降”组的生存期长于p53表达“增加”组的生存期(P<0.05)。结论:术前动脉化疗对胃癌细胞有明显的促进凋亡作用,可显著降低胃癌组织p53蛋白的表达,提高患者的生存期。

Effect of preoperative intra-arterial chemotherapy on apoptosis and p53 expression of gastric cancer

BACKGROUND & OBJECTIVE: Regional chemotherapy is charactized by a high drug concentration in tumor tissues and slight side-effects. Some significant histopathological changes were observed in the patients with gastric carcinoma treated by selective intra-arterial infusion chemotherapy before operation. The aim of this study was to investigate the effect of preoperative intra-arterial chemotherapy on apoptosis and p53 expression in human gastric cancer and its clinical significance. METHODS: The apoptosis was examined by terminal uridine deoxynucleotide nick end labeling (TUNEL) and the expression of p53 was detected with immunohistochemistry in 33 patients with gastric carcinoma pre- and post-chemotherapy respectively. RESULTS: Apoptosis index(AI) was significantly higher in the post-chemotherapeutic patients than in the pre-chemotherapeutic ones (19.29 +/- 6.48 versus 9.24 +/- 5.03, P < 0.01). In contrast, the positive expression rate of p53 was significantly lower, in the post-chemotherapeutic patients, than in the pre-chemotherapeutic ones(30.30% versus 54.55%, P < 0.05). In the post-chemotherapeutic patients, the droped group of p53 expression were strongly associated with a better clinical response(P < 0.05). CONCLUSIONS: Preoperative intra-arterial chemotherapy could enhance the apoptosis of gastric cancer cell, decrease the level of p53 expression and keep the patients for a longer survival.