术前区域化疗联合放疗对低位直肠癌术后复发及P53表达的影响  

The effect of PRAC combined with radiation on the expression of P53 of tumor cells and the postoperative recurrence in low rectal carcinoma

作　　者：李天煜[1] 陈博艺[1] 程军[1] 高翔[1] 邓国荣[1] 许建德[1] 李冲[1] 陈恩碧[1] 郑慧琼[1] 

机构地区：[1]广东医学院湛江中心医院肝肠中心,524037

出　　处：《岭南现代临床外科》2007年第4期250-252,共3页Lingnan Modern Clinics in Surgery

基　　金：广东省卫生厅科研基金资助项目(A2005734);湛江市科技局科技攻关项目(200558M0516)

摘　　要：目的探讨术前区域动脉灌注化疗(Preoperative regional intra-aterial chemotherapy,PRAC)联合放疗对低位直肠癌术后复发及P53表达的影响。方法对45例低位直肠癌病例随机分为3组,每组各15例,A组进行术前化、放疗,B组术前单纯放疗,C组术前未行任何化、放疗。采用免疫组化S-P法检测每例治疗前及手术后的P53表达。所有病例均得到12个月以上的随访。结果全部施行根治性切除术。A组治疗前后P53阳性表达分别为53.33%(8/15)和20.00%(3/15),B组分别为60.00%(9/15)和33.33%(5/15),差异有统计学意义(P<0.01);C组分别为53.33%(8/15)和40.00%(6/15),差异无统计学意义(P>0.05)。3组治疗前P53阳性表达之间无明显差异,3组术后P53阳性表达之间差异有统计学意义(P<0.01)。A组复发率6.67%(1/15),B组13.33%(2/15),C组26.67%(4/15),A组与B组的复发率均低于C组,差异有统计学意义(P<0.05)。A组保肛率40.00%(6/15),B组26.67%(4/15),C组6.67%(1/15),A组与B组的保肛率均高于C组,差异有统计学意义(P<0.05)。结论低位直肠癌采用PRAC联合放疗可以降低P53表达和减少复发率、提高保肛率,它是对低位直肠癌治疗的有效和合理的的措施。Objective To study the preoperative regional intra-aterial chemotherapy（PRAC） on the expression of P53 of tumor cells and the postoperative recurrence in low rectal carcinoma. Methods 45 cases of low rectal carcinoma were randomly divided into 3 equal groups,group A （PRAC Combined with Radiation） ,group B （preoperative radiotherapy） ,group C （without PRAC or preoperative radiotherapy）. Using immunohistochemistry （S-P） were detected and analysed. The expression of P53 of tumor cells before treatment and after operation.All cases were followed-up for at least 12 months. Results All the patients underwent radical resections successfully. The expression of P53 of tumor cells before treatment in group A was 53.33%, obviously more than that of the postoperation （20.00%,P〈0.01）. The P53 of tumor cells before treatment in group B was 60.00%,obviously more than that of the postoperation （33.33% ,P〈0.01）.There was no difference in group C （53.33% ,40.00% ,P〉0.05）. The P53 of tumor cells in Group A of postoperation was significantly lower as compared with Group B and C （P〈0.01）.The local recurrence rate in group A was 6.67%,while in group B it was 13.33%,obviously lower than that in group C （26.67%）（P〈 0.05）.The reserving anus rate in group A was 40.00% ,in group B 26.67%, obviously more than that in group C （6.67%）（P〈0.05）. Conclusion PRAC Combined with Radiation for low rectal carcinoma can decrease the expression of P53 of tumor cells,decrease local recurrence rate,and increase the reserving anus rate. Therefore this therapy is safe, rational and effective for improving the therapeutic results in low rectal carcinoma.

关 键 词：术前区域动脉灌注化疗 低位直肠癌 局部复发 P53表达 

分 类 号：R730.5[医药卫生—肿瘤] R735.3[医药卫生—临床医学]