5-Fu缓释剂局部植入对进展期直肠癌淋巴道转移的影响  

Impact of Embedding Sustained Release 5-Fu in Rectum Submucosa on Lymphatic Metastasis in Patients with Advanced Rectal Cancer

作　　者：杨宏伟[1] 路忠志 肖秀丽[3] 吴斌[4] 

机构地区：[1]遂宁市中心医院乳腺外科,四川遂宁629000 [2]淄博市第一人民医院普外科,山东淄博255200 [3]泸州医学院附属医院病理科,四川泸州646000 [4]泸州医学院附属医院普外科,四川泸州646000

出　　处：《实用临床医学（江西）》2010年第11期39-42,45,共5页Practical Clinical Medicine

摘　　要：目的探讨术前直肠黏膜下植入5-Fu缓释剂对进展期直肠癌淋巴道转移的影响。方法 96例Dukes B、C期直肠癌患者按序贯实验分成2组,其中试验组45例,对照组51例。试验组于术前5～10 d经肛门直肠黏膜下植入5-Fu缓释剂100～150 mg.m-2。2组患者均施以Dixon术。术后标本中淋巴结计数,计算淋巴结转移率(MLR)和淋巴结转移度(LNR)。转移淋巴结计算细胞凋亡指数(AI)。阴性淋巴结CK19为一抗免疫组化检查,阳性记为淋巴结微转移(MM)。结果试验组MLR(37.8%)及LNR(10.0%)均低于对照组(45.1%和12.5%)(P=0.468和0.118)。试验组阳性淋巴结AI(0.086±0.047)高于对照组(0.036±0.042)(P<0.001)。试验组淋巴结MM率、MM度(11.1%和8.3%)低于对照组(29.4%和19.3%)(P=0.028和P=0.019)。结论术前直肠黏膜下植入5-Fu缓释剂对进展期直肠癌淋巴结转移和微转移灶均有抑制效应,尚不能显著降低MLR、LNR。Objective To explore the effect of embedding sustained release 5-Fu in rectum submucosa on lymphatic metastasis in patients with advanced rectal cancer.Methods Ninety-six patients with Dukes＇ B and C rectal cancer were divided into experimental group（45 patients） and control group（51 patients）.Patients in experimental group were imbedded sustained release 5-Fu（100～150 mg·m-2） in rectum submucosa 5～10 days before surgery.All patients underwent Dixon operation.The number of lymph nodes retrieved within the postoperative specimen were counted and metastatic lymph node ratio（MLR） and lymph node metastasis ratio（LNR） were calculated,and the apoptotic index（AI） was calculated in metastatic lymph nodes.Negative lymph nodes were immunohistochemically stained with CK19,and positive nodes were micrometastasis（MM）.Results MLR and LNR in experimental group were lower than those in control group,but the differences were not statistically significant（37.8% vs 45.1%,P=0.468 and 10.0% vs 12.5%,P=0.118,respectively）.AI in experimental group（0.086±0.047） was obviously higher than that in control group（0.036±0.042）（P0.001）.The rate of lymph node MM and the degree of lymph node MM in experimental group（11.1% and 8.3% and were lower than those in control group（29.4% and 19.3%）,（P=0.019,respectively）.Conclusion Implantation of sustained release 5-Fu in rectum submucosa can inhibit lymph node metastasis and MM in patients with advanced rectal cancer,but it can not significantly decrease MLR and LNR.

关 键 词：直肠癌 5-FU缓释剂 淋巴结转移 细胞凋亡指数 

分 类 号：R735.35[医药卫生—肿瘤]