周期性区域阻断大剂量动脉灌注化疗近期疗效探析  

The Investigation and Analysis of the Short-term Effectiveness of Periodic Blocked Regional and High-dose Arterial Limb Infusion for Chemotherapy of Osteosarcoma

作　　者：戴闽[1] 聂涛[1] 姚浩群[1] 欧阳慧[1] 宗世璋[1] 李明军[1] 

机构地区：[1]江西医学院第一附属医院骨科,江西南昌330006

出　　处：《江西医学院学报》2005年第2期46-48,共3页Acta Academiae Medicinae Jiangxi

基　　金：江西省教育厅资助项目(E040506)

摘　　要：目的探讨周期性区域阻断大剂量动脉灌注化疗的可行性及其临床应用价值。方法对19例骨肉瘤患者周期性区域阻断大剂量动脉灌注化疗前活检病理标本和化疗后手术切除的病理标本分别应用DNA原位末端标记法、免疫组化S P法检测骨肉瘤细胞凋亡及Survivin蛋白表达,同时记录患者化疗前后的临床疼痛症状、邻近关节功能及患肢瘤体的最大周径。结果化疗后骨肉瘤细胞凋亡指数为15.47%,明显高于化疗前的7.21%,化疗后Survivin阳性表达率(42.1%)较化疗前(78.95%)明显减少,患者疼痛症状明显减轻,邻近关节功能改善,瘤体最大周径缩小。结论周期性区域阻断大剂量动脉灌注化疗可以诱导骨肉瘤细胞凋亡的增加,降低骨肉瘤组织Sur vivin蛋白的表达,是骨肉瘤综合治疗的有效措施之一。Objective To study the effectiveness and clinical value of periodic blocked regional and high-dose arterial limb infusion. Methods The apoptosis index was examined by terminal uridine deoxynucleotide nick end labeling and the expression of survivin was detected with immunohistochemistry (S-P) technique, at the same time, observed the clinical pain, the functional improvement of adjacent joint and measured the maximum circumference of tumor in 19 patients with osteosarcoma pre-and post-arterial limb infusion respectively. Results The apoptosis index was significantly higher in the post-chemotherapeutic patients than thet in the pre-chemotherapeutic ones (15.47% verus 7.21%, P<0.05). In contrast, the positive expression rate of survivin was significantly lower in the post-chemotherapeutic patients than in the pre-chemotherapeutic ones (42.1% verus 78.95%, P<0.05). The pain symptom of those patients was clearly relieved, the function of adjacent joint was improved and the maximum circumference of tumor was decreased. Conclusion periodic blocked regional and high-dose arterial limb infusion could induce the apoptosis of osteosarcoma cell, decrease the level of survivin expression. It could be one of effective comprehensive treatments of osteosarcoma.

关 键 词：骨肉瘤 细胞凋亡 SURVIVIN 

分 类 号：R730.53[医药卫生—肿瘤]