抗CEA单克隆抗体导向治疗大肠癌的病理学研究  

Anti CEA monoclonal antibody targeting therapy for colorectal carcinoma

作　　者：卢献平[1] 李宝金[1] 陈声乐[1] 吕斌[1] 蒋宁一[1] 

机构地区：[1]中山医科大学孙逸仙纪念医院

出　　处：《世界华人消化杂志》1999年第4期329-331,共3页World Chinese Journal of Digestology

摘　　要：目的研究抗ＣＥＡ单克隆抗体丝裂霉素治疗大肠癌的病理学改变，以提高大肠癌综合治疗的疗效．方法大肠腺癌患者２０例，随机分成３组，分别进行化疗（ｉｖ丝裂霉素８ｍｇ），ｉｖ抗ＣＥＡ单克隆抗体－丝裂霉素（含丝裂霉素８ｍｇ）导向治疗以及顿服心得安１０ｍｇ＋ｉｖ抗ＣＥＡ单克隆抗体－丝裂霉素（含丝裂霉素８ｍｇ）导向治疗．其后３ｄ对所有患者均行手术切取标本进行病理组织学观察，ＡｇＮＯＲ检测及肿瘤浸润淋巴细胞计数．结果①病理退变程度：化疗组有效率为７１４％，抗ＣＥＡ单克隆抗体－丝裂霉素组有效率为８５７％，顿服心得安＋抗ＣＥＡ单克隆抗体－丝裂霉素组为８３３％，３组各组间无显著性差异（Ｐ＞００５）．②ＡｇＮＯＲ检测：抗ＣＥＡ单克隆抗体－丝裂霉素组与化疗组之间癌细胞ＡｇＮＯＲ／核均数其差异有显著性（ｔ’＝２７０，Ｐ＜００５）；顿服心得安＋抗ＣＥＡ单克隆抗体－丝裂霉素组与化疗组比较，癌细胞ＡｇＮＯＲ／核均数其差异也有显著性（ｔ’＝３２０，Ｐ＜００５）；两导向治疗组之间癌细胞ＡｇＮＯＲ／核均数其差异无显著性（Ｐ＞００５）．③肿瘤浸润性淋巴细胞计数：各组中Ｔ细胞ＣＤ＋３与Ｂ细胞ＣＤ＋２０之间有显著性差异（Ｐ＜００１）；?AIM To study the pathohistological changes of colorectal carcinoma (CRC) after targeting therapy so as to improve the therapeutic effect for this tumor. METHODS Twenty patients receiving 3 day preoperative chemotherapy were divided into three groups: group A (7 patients receiving mitomycin C 8 mg ), group B (7 patients receiving monoclonal antibody C50 2 mg and mitomycin C 8 mg ) and group C (6 patients receiving inderal 10 mg , C50 2 mg and mitomycin C 8 mg ). Effect of the preoperative chemotherapy was assessed by histologic findings of the resected specimens, by silver staining proteins score of the nucleolar organizer region (AgNOR) and by infiltrating lymphocytes' subsets and counts with streptavidin peroxidase stain (SP). RESULTS Apoptosis of CRC cells were found in five patients (71 4%) in group A, six patients (85 7%) in group B and five patients in group C, without significant difference among the groups ( P >0 05). AgNOR score of the resected tumor was lower in group B than in group A with significant difference between the two groups ( t '=2 70, P <0 05). There was no significant difference between groups B and C ( P >0 05). The infiltrating lymphocytes were predominantly T lymphocytes (CD + 3). There were no significant difference in the counts of T lymphocytes (CD + 3) or B lymphocytes (CD + 20 ) among groups ( P >0 05). But there were significant differences between the counts of T lymphocytes (CD + 3) and that of B lymphocytes (CD + 20 , P <0 01). CONCLUSION The therapeutic effect is better in patients receiving antibody drug conjugate (C50 MMC or inderal+C50 MMC) than in those only receiving mitomycin C. The treatment with MMC and C50 MMC can cause apoptosis of the CRC cells. The infiltrating lymphocytes are predominantly T lymphocytes after treatment of MMC, C50 MMC, and inderal and C50 MMC.

关 键 词：大肠肿瘤 单克隆抗体 丝裂霉素C 

分 类 号：R735.340.5[医药卫生—肿瘤] R730.53[医药卫生—临床医学]