脱氧氟尿苷诱导胃腺癌细胞凋亡的临床研究  

A clinical study on apoptosis and proliferation of gastric adenocarcinoma cells induced by 5′-deoxy-5-fluorouridine (5′-DFUR)

作　　者：赵文和[1] 王世夫 丁伟[3] 盛建明[1] 马志敏[1] 滕理送[1] 王敏[1] 罗斌 吴福生[1] 

机构地区：[1]浙江大学医学院附属第一医院肿瘤外科,杭州310003 [2]浙江省温岭市第三人民医院外科 [3]浙江大学医学院附属第一医院病理科,杭州310003

出　　处：《中华普通外科杂志》2005年第3期184-186,共3页Chinese Journal of General Surgery

基　　金：浙江省教育厅资助项目 (2 0 0 10 5 3 6)

摘　　要：目的　了解术前化疗对胃腺癌细胞凋亡的影响。方法　采用抽签法术前随机分为口服脱氧氟尿苷(5′- DFUR)组(18例)、静脉输注5- FU +CF组(16例)及对照组(2 0例)。化疗结束后第1～2天手术。采用免疫组织化学及TUNEL法检测癌细胞增殖指数(PI)及凋亡细胞指数(AI)。结果　PI在5′-DFUR组(40±13)、5 - FU +CF组(41±15 )明显低于对照组(5 8±16 ) ,差异有统计学意义(P =0 . 0 0 0 ) ;AI在5′- DFUR组(14±9)、5 - FU +CF组(14±10 )明显高于对照组(7±7) ,差异有统计学意义(P =0 . 0 17)。4 4例获得随访。总的0 . 5、1、2年生存率分别为93%、86 %、70 % ,0. 5、1、2年无瘤生存率分别为89%、77%、6 7%。3组术后生存时间差异无统计学意义。结论　术前3～5d短程口服5′- DFUR化疗可诱导胃腺癌细胞凋亡,降低癌细胞增殖指数,但不能改善术后生存情况。Objective To study apoptosis and proliferation of gastric adenocarcinoma cells induced by 5′-deoxy-5-fluorouridine (5′-DFUR).Methods Patients of gastric carcinoma were divided randomly into three groups before operation: group 1 (18 cases) receiving 5′-DFUR 800～1200 mg/d×3-5 d po, group 2 ( 16 cases ) treated by 5-FU 500 mg+CF 200 mg/d×3-5 d and group 3 (20 cases) serving as control.One or two days after chemotherapy, patients were operated on. The proliferation index (PI) and apoptosis index (AI) of gastric carcinoma cells were evaluated by in-situ TUNEL and En Vision PCNA immunohistochemical method.Results PI in group 1 (40±13) and group 2 (41±15) were lower than that in control (58±16), ( P =0.000). AI in group 1 (14±9) and group 2 (14±10) were significantly enhanced than that in group 3 (7±7), ( P =0.017).A total of 44 patients were followed up, with 0.5-? 1-? 2-year survival rates of 93%? 86% and 70%, respectively.The disease free 0.5-? 1-? 2- year survival rates were 89%? 77% and 67%, respectively.The survival rates among three groups were not statistically different.Conclusion Preoperative short course 5′-DFUR administration do not improve prognosis of postoperative patients with gastric cancer.

关 键 词：癌细胞凋亡 脱氧氟尿苷 临床研究 胃腺 5-FU+CF 细胞增殖指数 免疫组织化学 凋亡细胞指数 TUNEL 对照组 统计学 术前化疗 静脉输注 无瘤生存 时间差异 术后生存 短程口服 生存情况 生存率 

分 类 号：R735.2[医药卫生—肿瘤]