动脉灌注化疗对乳腺癌的组织病理学影响

目的 :探讨乳腺癌术前动脉插管灌注化疗对肿瘤组织形态的影响。　方法 :对 2 0例乳腺癌患者以Seldinger法插管行内乳动脉造影并行灌注化疗。同时选择 16例未作动脉灌注化疗的乳腺癌患者作为对照组 ,观察两组手术切除标本的组织学改变。　结果 :动脉灌注化疗组术后病理观察均发现血管周围癌细胞发生核固缩、碎裂 ,胞质凝固、坏死 ,细胞间质水肿 ,炎细胞大量浸润 ,癌区血管出现内膜增厚、肿胀、痉挛 ,内皮细胞变性、脱落。而对照组无或仅有轻度上述改变。　结论 :术前选择性动脉插管灌注化疗可显著改变乳腺癌组织的形态 ,明显增加肿瘤细胞坏死。动脉血栓形成至少在动脉插管化疗早期并非是导致肿瘤缺血 ,细胞坏死甚至死亡的主要原因

Pathological and clinical effects of preoperative arterial infusion chemotherapy on the breast cancers

Objectives：To investigate the pathological and clinical effect of preoperative arterial infusion chemotherapy on breast cancers.Methods:Twenty patients with breast carcinoma received regional arterial angiography by Seldinger's procedure followed by arterial infusion chemotherapy.Sixteen patients who didn't undergo preoperative chemotherapy were selected as controls.All the operation specimens were analyzed by the same pathologist.Results:Histological analysis of the two groups revealed the following results:① cancer tissue necrosis increased in the arterial chemotherapy group;②karyopyknosis,karyorrhexis coagulation and necrosis of cytoplasm around the vascular vessels as well as interstitial edema were found in the tumor tissue,invasion of inflammatory cells,intimal proliferation thrombus and inflammation of vessels could also be seen.All the changes were much severe in the infusion chemotherapy group than in the controlled group;Conclusions:Histological changes are significant after preoperative arterial infusion chemotherapy for breast carcinoma.