3种不同术前辅助治疗方法对低位直肠癌细胞凋亡的影响

目的:探讨3种不同术前辅助治疗方法对低位直肠癌细胞凋亡的影响.方法:对91例低位直肠癌病例分为4组,A组19例进行术前区域动脉灌注化疗(Preoperative regional intra-arteral chemotherapy,PRAC)联合放疗,B组30例进行术前腔内热疗(preoperative endocavitary hyperthermia,PEH)联合放疗,C组15例术前单纯放疗,D组27例术前未行任何辅助治疗.采用原位末端标记技术(TUNEL法)检测每例治疗前及手术后的凋亡细胞. 结果:全部施行根治性切除术.所有4组治疗前的凋亡指数(Apoptosis Indexes,AI)之间无明显差异.A、B、C 3组治疗后AI均明显高于各组治疗前AI(P＜0.01).治疗后的4组AI相比,A组(5.389±0.517)%、B组(4.985±0.428)%、C组(2.757±0.251)%,均高于D组(0.877±0.139)%,A组和B组AI又均高于C组,差异均有统计学意义(P＜0.01);A组与B组AI无明显差异.结论:低位直肠癌PRAC联合放疗与PEH联合放疗均可以明显促进癌细胞凋亡,提示术前通过这两种方法治疗直肠癌可收到更好的效果.

THE EFFECT OF THREE TYPES OF PREOPERATIVE ADJUVANT THERAPY ON THE APOPTOSIS OF TUMOR CELL IN LOW RECTAL CARCINOMA

Objective: To explore the effect of three different preoperative treatment on the apoptosis of tumor cell in low rectal carcinoma.Methods:91 cases of low rectal carcinoma were randomly divided into four groups: Group A included 19 cases treated with PRAC combined radiation, Group B included 30 cases treated with PEH combined radiation,Group C included 15 cases treated with preoperative radiotherapy,and Group D included 27 cases without any adjuvant therapy. The method of TUNEL was used to determine the apoptosis of tumor cells at the time of prior treatment and after operation. Result: All cases were given radical excision. There was no significant difference in the pretherapeutic apoptosis indexes(AI) among the four groups. The postoperation AI in Group A, B and C groups was obviously higher than the pretherapeutic (P<0.01). The postoperation AI in Group A and B was significantly higher than Group C and D (P<0.01). Conclusion: PRAC combined radiation or PEH combined radiation can accelerate the apoptosis of tumor cells in low rectal carcinoma, which implies that a better therapeutic result may be obtained by these two methods of preoperative treatment.