术前腔内热疗加放疗对低位直肠癌细胞凋亡和增殖的影响  

The effect of preoperative endocavitary hyperthermia combined with radiation on apoptosis and proliferation of cancer cells in lower rectum

作　　者：唐毓林[1] 唐宗江[2] 郭云[2] 

机构地区：[1]广西壮族自治区民族医院,南宁530001 [2]广西医科大学第一附属医院,南宁530021

出　　处：《结直肠肛门外科》2007年第2期71-75,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的:探讨术前腔内热疗(Preoperative endocavitary hyperthermia,PEH)联合放疗对低位直肠癌细胞凋亡和增殖的影响。方法:将72例低位直肠癌患者分为3组:A组30例接受术前腔内热疗加放疗,B组15例单纯放疗,C组27例未行热疗及放疗。采用HE染色检测3组治疗前后癌细胞的凋亡指数;S-P免疫组织化学法检测3组治疗前后癌组织中PCNA、bcl-2和P53蛋白的表达,根据PCNA染色计算增殖指数,比较3组上述指标治疗前后及治疗后之间的变化。结果:A组治疗后癌细胞凋亡指数(apoptotic index,AI)(5·085±0·428)较治疗前(0·872±0·151)明显增加(P<0·001);癌细胞的增殖指数(prolif-erative index,PI)(37·213±19·564)较治疗前(46·245±20·804)明显下降(P<0·001);治疗后癌细胞bcl-2、P53蛋白的阳性表达均较治疗前明显下调(P<0·05)。B组治疗后癌细胞AI(2·757±0·251)较治疗前(0·875±0·098)明显增加(P<0·001);癌细胞PI(41·335±18·778)较治疗前(45·755±21·478)明显下降(P<0·001);治疗后癌细胞bcl-2、P53蛋白的阳性表达均较治疗前明显下调(P<0·05)。C组上述指标无明显改变。治疗后组间比较,A组的AI高于B组(P<0·05),A组的PI低于B组(P<0·05);bcl-2、P53蛋白阳性表达A组与B组无明显差异(P>0·05)。结论:PEH加放疗可使低位直肠癌AI明显增加,PI明显下降,bcl-2、P53蛋白阳性表达下调,说明PEH加放疗可显著诱导低位直肠癌细胞的凋亡,抑制其增殖。Objective： To explore the effect of preoperative endocavitary hyperthermia （PEH） combined with radiation on apoptosis and proliferation of cancer cells in lower rectum. Methods： Seventy-two cases with advanced cancer in the lower rectum were divided into 3 groups： 30 cases in A group were treated by PEH combined with radiation,15 cases in B group only by preoperative radiotherapy,27 cases in C group by neither PEH nor preoperative radiotherapy. Apoptosis was examined by haematoxylin and eosin staining and the expression of proliferating cell nuclear antigen （PCNA）, Bcl-2 and p53 protein by immunohistochemical staining. The effect of this treatment was judged by apoptotic index （AI）, proliferative index （PI） and the changes of positive expression of bcl-2, P53 protein. Results： In group A, the post-treatment AI （5.085±0.428） was higher than that of pretreatment （0.872±0.151）（P〈0.001）, and the post-treatment PI（37.213±19.564） was lower than that of pretreatment（46.245±20.804） （P〈0.001）;The positive expression of bcl-2, p53 protein after treatment were lower than that of pretreatment （P〈0.05）. In group B, the post-treatment AI （2.757±0.251） was higher than that of pretreatment（0.875±0.098）（P〈0.001）,and the post-treatment PI（41.335±18.778） was lower than that of pretreatment（45.755±21.478）（P〈0.001）; The positive expression of bcl-2, p53 protein after treatment were lower than that of pretreatment （P〈0.05）. But those in group C had no obvious changes. AI, PI in group A were higher than that in group B after treatment （P〈0.05）. There was no difference in the positive expression of bcl-2, p53 protein in group A after treatment compared with that in group B（P〉0.05）. Conclusion： PEH combined with radiation can down-regulate the expression of bcl-2, p53 protein in tumor tissue, and significantly induced apoptosis and suppress proliferation of cancer cells in lower rectum.

关 键 词：术前腔内热疗 低位直肠癌 凋亡指数、增殖指数 BCL-2基因 P53基因 

分 类 号：R735.37[医药卫生—肿瘤]