喉癌术前平阳霉素诱导性化疗的临床及基础研究  

Clinical and Basic Research on Neoadjuvant Chemotherapy with PYM in the Treatment of Laryngeal Carcinoma

作　　者：高明[1] 余海峰[1] 徐本义[1] 葛正津[1] 于洋[1] 魏松锋[1] 李树玲[1] 

机构地区：[1]天津医科大学附属肿瘤医院,天津市300060

出　　处：《中国肿瘤临床》2006年第13期757-761,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:观察术前应用平阳霉素对喉鳞状细胞癌诱导性化疗的近期疗效,检测化疗后肿瘤组织及肿瘤退缩区生物学特性变化和分子生物学改变。方法:1)对50例喉鳞状细胞癌患者采用平阳霉素诱导性化疗,每次16mg,隔日给药,剂量在112～192mg之间。观察肿瘤的缓解及不良反应,并分析相关因素与疗效的关系。2)对24例应用平阳霉素诱导性化疗的喉鳞状细胞癌患者,化疗后一周内手术,手术中取肿瘤组织、退缩区组织和正常组织,进行常规病理、流式细胞仪、PCNA、p53、Bcl-2和CD44v6检查。结果:喉癌对平阳霉素单药诱导性化疗总有效率为80.2%(推荐剂量总有效率87.9%),化疗效果与病理分级和给药剂量有相关性,与肿瘤临床分期和原发灶部位无相关性。副作用主要为发热、消化道反应、皮肤症状和WBC增高等;化疗后肿瘤组织和退缩区组织细胞凋亡增高,G1、S期细胞比率较未经化疗肿瘤组织高,但G2期细胞的比率明显降低;PCNA、p53、Bcl-2和CD44v6在肿瘤组织中的表达较未经化疗的肿瘤组织有所下降,在退缩区组织中的表达与正常组织无显著性差异,而与肿瘤组织有明显差异。结论:1)喉癌实施术前平阳霉素诱导性化疗近期疗效较理想,副作用小。分次给药,总剂量160mg可以作为术前诱导性化疗的一个标准剂量,高龄或肺部疾患的喉癌患者应酌情减量。2)诱导性化疗后肿瘤细胞大量凋亡坏死,其细胞增殖状况、抑制凋亡水平及肿瘤转移倾向等方面较化疗前已明显下降;肿瘤退缩区组织相应检测已近正常。pingyangmycin Objectives： To evaluate the short-term effects of neoadjuvant chemotherapy with （PYM） in the treatment of laryngeal squamous cell carcinoma and to detect the changes in physiology and molecular biology in tumors compared with tissue specimens from the surrounding normal tissue after neoadjuvant chemotherapy. Methods： a）. Fifty cases of laryngeal squamous cell carcinoma were treated with 16 mg of PYM every other day with a total dose of 112 to 192 mg. before surgery. The short-term curative effect was evaluated and the side effects of the drug were observed, b）. Twenty-four cases with laryngeal squamous-cell carcinoma were treated with PYM as neoadjuvant therapy, and the surgical procedures were conducted one week later. Pathology, flow cytometry and immunohistochemical staining for, PCNA, p53, Bcl-2, and CD44v6 were carried out on the tumor sampies, specimens from the adjacent normal tissue and normal tissue. Results： a）. The short-term curative rate of PYM in the cases with laryngeal squamous cell carcinoma was 80.2% （The curative rate with the recommended dose was 87.9%）. The response rate to PYM was related to the degree of cellular differentiation and drug dosage, but not to the clinical stage or primary location of the tumors. The side effects included fever, digestive reaction, skin symptoms and higher WBC. b）. After chemotherapy, apoptosis was higher in the tumors and the surrounding area than before -chemotherapy. The G1 and Sphase ratios after chenmtherapy were higher than thos before chemotherapy, but the G2- phase ratio was obvirnsly lower coral-tared to pre-chemotherapy. The expressions of PCNA, p53, Bcl-2 and CD44v6 in tumor samples after chemotherapy were lower than those before them.therapy. There was hi, difference in PCNA. p53, Bcl-2 and CD44v6 expression in the area adjacent to the tumor compared to normal tissue, but there was a significant difference between the tumor-adjacent area anti the tumor.Conclusion： a）. Neoadjuvanl chemotherapy with PYM is fea

关 键 词：平阳霉素 诱导性化疗 流式细胞仪 PCNA p53 BCL-2 CD44V6 

分 类 号：R739.65[医药卫生—肿瘤]