动脉灌注新辅助化疗对大肠癌组织PCNA、VEGF、P53及MVD表达的影响

目的检测动脉灌注新辅助化疗后大肠癌癌组织中PCNA、VEGF、P53及MVD表达的变化，探讨其对大肠癌治疗的意义。方法选取病理诊断明确的进展期大肠癌患者128例，随机分为实验组68例、对照组60例，实验组术前行动脉灌注化疗1-2周期，对照组直接行手术治疗，应用免疫组化方法分别检测治疗前病理活检标本及手术后癌组织中PCNA、VEGF、P53及MVD的表达。结果动脉灌注新辅助化疗后完全缓解22．1％，部分缓解44．1％，总有效率达66．2％。术后癌组织中PCNA、VEGF及MVD的表达实验组低于对照组（P〈0．05）。实验组动脉灌注新辅助化疗后临床有效者癌组织中PCNA、VEGF及MVD的表达降低（P〈0．05）；临床无效者化疗前后PCNA、VEGF及MVD的表达无显著性差异（P〉0．05）。P53的表达在实验组与对照组之间及实验组化疗前后均无显著性差异（P〉0．05）。实验组平均疾病无进展时间为37个月，对照组为20个月，二者相比有统计学差异（P〈0．05）。结论动脉灌注新辅助化疗对进展期大肠癌的治疗疗效肯定，PCNA、VEGF及MVD的联合检测可以作为大肠癌动脉灌注新辅助化疗疗效的客观评价指标。

Effects of neoadj uvant chemotherapy via arterial infusion on the expressions of PCNA,VEGF, P53 and MVD in colorectal carcinoma

Objective To investigate the expressions of PCNA, VEGF, P53 and MVD in the tissues of colorectal carcinoma after neoadjuvant chemotherapy via arterial infusion and the significance of neoadjuvant chemotherapy via arterial infusion in the treatment of colorectal carcinoma. Methods 128 patients with advanced colorectal carcinoma were divided randomly into 2 groups, 68 patients in the test group adopted neoadjuvant chemotherapy via arterial infusion for 1-2 courses before operation, and 60 patients in control group adopted operation only. The expressions of PCNA, VEGF, P53 and MVD of all patients sample were detected separately around treatment by immunohistochemical method. Results After neoadjuvant chemotherapy via arterial infusion, complete response was 22.1%, partial response was 44.1%, and complete response add partial response was 66.2%. After operation, the expressions of PCNA, VEGF and MVD of the colorectal carcinoma tissues in the test group were lower than those in the contrast group （P 〈0.05）, but the expressions of P53 was no significantly changing between two groups （P 〉0.05）. In the test group those patients who reacted to neoadjuvant chemotherapy, the expression rates of PCNA, VEGF and MVD decreased significantly after the treatment （P 〈0.05）, but the expressions of those didn＇t change obviously in other patients （P 〉0.05）. The progressionfree survival was 37 months in the test group and 20 months in the contrast group, the statistics data is P 〈0.05, which is notable meaning. Conclusion Neoadjuvant chemotherapy via arterial infusion is efficient in the treatment of advanced colorectal carcinoma. Combining detection of the expressions of PCNA, VEGF, P53 and MVD can be used as an objective index for the evaluation of the efficacy of neoadiuvant chemotherapy via arterial infusion.