局部进展期胰腺癌术前介入治疗新方法的应用

目的　通过术前联合化疗药物区域性动脉灌注介入治疗 ,探讨局部进展期胰腺癌介入治疗新方法应用的疗效。方法　 94例局部进展期胰腺癌患者术前进入介入治疗组和未介入治疗组 ,观察介入治疗前后肿瘤大小的改变、疼痛缓解率、血清肿瘤标志物的变化和副反应程度 ,通过免疫组化法检测介入治疗对肿瘤细胞凋亡和凋亡基因bcl 2、bax表达的影响 ,并比较两组患者手术切除率。结果　术前介入组和未介入组的手术切除率分别为 4 6 .8%和 2 3.3% (P <0 .0 5 ) ;术前介入治疗组肿瘤细胞调亡明显增加 ,肿瘤细胞bcl 2基因表达明显减少 ,而bax基因的表达显著增加 (P <0 .0 5 ) ;介入治疗能显著降低血清肿瘤标志物水平 ,并能明显缓解患者疼痛 (缓解率为 6 8.6 % ,P <0 .0 5 )。结论　术前介入治疗对胰腺癌肿瘤细胞有明显的杀伤和诱导凋亡作用 ,有助于提高手术切除率和改善患者疾病相关症状 ,是胰腺癌综合治疗的有效措施之一

Study of preoperative intra-arterial infusion chemotherapy for patients with locally advanced pancreatic carcinomas

Objective To verify the effectiveness of preoperative intra-arterial infusion chemotherapy(IAC) for treatment of patients with locally advanced pancreatic carcinomas. Methods 94 patients with locally advanced pancreatic cancer proved by biopsy were divided into two groups: IAC group(64 cases) preoperatively and control group(30 cases) without IAC preoperatively in the same period. Change of tumor size, rate of tumor resection, level of serum tumor markers and disease-related symptoms were followed up. Apoptosis of tumor cell and expression of gene bcl-2, bax were also studied by immunohistochemical methods in resected samples. ResultsIntra-arterial infusion chemotherapy could contract the tumor size with result of much higher resection rate in IAC group than in control group(46.8% vs 23.3%). Apoptosis index of tumor cell in IAC group and expression of bax gene increased significantly, and expression of bcl-2 decreased remarkably compared with control group (P<0.05). Disease-related symptoms were improved obviously in IAC group contrasted with control group. There was significantly change of level of serum tumor markers after intra-arterial infusion chemotherapy. Conclusions It was demonstrated that preoperative intra-arterial infusion chemotherapy could increase the surgical resection rate of locally advanced patients with pancreatic carcinomas by enhancement of tumor cell apoptosis and improve the disease-related symptoms.