肺癌术中胶体^(32)P组织间照射治疗淋巴道隐匿性转移灶  

Effect of ^(32)P-colloid interstitial irradiation on the treatment of occult lymphatic metastasis during lung cancer resection

作　　者：刘璐[1] 刘志勇[2] 童冠圣[3] 李旭东[2] 谢亦山[4] 高宏[4] 高文[1] 黄鹰[1] 封国生[4] 

机构地区：[1]东南大学核医学技术研究所,南京210009 [2]东南大学附属中大医院心胸外科 [3]铁道部北京铁路总医院核医学科 [4]铁道部北京铁路总医院肿瘤外科

出　　处：《中华核医学杂志》2005年第1期33-36,共4页Chinese Journal of Nuclear Medicine

基　　金：铁道部科研基金资助项目 (J1998Z0 2 1) ;江苏省卫生厅科研基金资助项目 (H2 0 0 117)

摘　　要：目的　探讨胶体32 P在肺癌手术中组织间照射对淋巴道隐匿性转移灶的治疗作用。方法　对 73例肺癌患者采用手术切除瘤体配合胶体32 P间质注射治疗 ,以同期同病种单纯手术治疗 5 8例为对照 ,观察术后胶体32 P在体表动态分布情况、并发症发生率、不同病理类型各组术后锁骨上淋巴结(SCL)转移率及 1、3和 5年生存率。结果　手术 +胶体32 P组与对照组均无手术死亡。两组淋巴结阳性率及术后主要并发症发生率差异均无显著性 (χ2 =0 .0 1 2、2 . 0 82、0 . 0 0 3,P均 >0. 0 5 ;χ2 =0 . 0 2 1～ 0 .1 4 4 ,P均 >0. 0 5 )。术后SCL转移发生率手术 +胶体32 P组明显低于对照组 (χ2 =4 .5 0 7～ 5 .348,P <0 . 0 5和 <0 . 0 1 )。手术 +胶体32 P组和对照组 1、3、5年生存率分别为 82 . 2 %、5 6. 2 %、38 .7%,77 .6 %、4 1. 7%、2 5. 5 %。其中 1年生存率组间比较差异无显著性 (χ2 =0 6 5 9,P >0 0 5 ) ,3和 5年生存率组间比较差异均有显著性 (χ2 =4. 2 0 7、3. 997,P均 <0. 0 5 )。结论　肺癌切除术中胶体32 P间质注射是一种安全、有效杀灭隐匿性转移灶的方法。Objective To study the effectiveness of interstitial irradiation by 32 P colloid on the occult metastasis during lung cancer resection. Methods Seventy three patients with lung cancer underwent resection of the tumor and interstitial administration of 32 P colloid. At the same period, 58 matched patients underwent surgical therapy only and served as the control group. After operation the dynamic distribution of body surface 32 P colloid activity, incidence of complications, rates of supra clavicular lymph node (SCL) metastasis in different pathologic patterns, and survival rates at 1,3,5 years after treatment were studied. Results No operative death occurred in these two groups. The incidences of lymph node metastasis and the incidences of major complications after operation were of no prominent differences between these two groups ( χ 2=0.012, 2.082, 0.003, P >0.05; χ 2=0 021～0.144, P >0.05). The incidence of post operative SCL metastasis in surgery plus 32 P colloid group was prominently lower than that in control group( χ 2=4.507～5.348, P <0.05, P <0.01).1 ,3 ,5 year survival rates of the former group were 82.2%,56.2% and 38.7%, those of the later group were 77.6%, 41.7% and 25.5%, respectively.In reviewing the 1 ,3 ,5 year survival rates in different pathologic pattern groups, there was no prominent statistical difference of the 1 year survival rates between the groups ( χ 2=0.659, P >0.05), but the differences of the 3 ,5 year survial rates between the groups were prominent ( χ 2=4.207、3.997, P <0.05). Conclusions Stromal injection of 32 P colloid during resection of lung cancer is a safe and effective procedure for controlling the occult lymphatic metastatic lesions and diminishing the focal relapse and distant metastasis, and it is bound to prolong the survival time of the patients.

关 键 词：^32P 隐匿性转移 肺癌 生存率 术后 对照组 淋巴 显著性 胶体 结论 

分 类 号：R734.2[医药卫生—肿瘤]