结直肠癌动脉灌注新辅助化疗后PCNA和MVD表达临床意义的观察  

Effect of neoadjuvant chemotherapy via arterial infusion on survival rate and expression of PCNA and MVD in colorectal carcinoma

作　　者：弥海宁[1] 何科基[1] 杨言苹[2] 李兴文[1] 那光玮[1] 赵晓宁[1] 李晓琴[3] 

机构地区：[1]甘肃省肿瘤医院外科,甘肃兰州730050 [2]甘肃省中医学院附属医院麻醉科,甘肃兰州730000 [3]甘肃省肿瘤医院病理科,甘肃兰州730050

出　　处：《中华肿瘤防治杂志》2011年第5期351-354,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨术前动脉灌注化疗对结直肠癌生存率的影响,评价PCNA和MVD对于其远期疗效的预测意义。方法:选择ⅡB、Ⅲ期的结直肠癌患者128例,随机分为试验组(动脉灌注新辅助化疗+手术)68例和对照组(直接手术)60例,并分别测定化疗前活检及手术切除后癌组织PCNA和MVD的表达情况,比较两组1、3和5年生存率及PCNA及MVD的表达变化。结果:试验组患者术后13、和5年生存率分别为95.3%、85.9%和44.6%,对照组分别为92.6%、75.9%和22.0%,1和3年生存率差异无统计学意义,5年生存率差异有统计学意义,P<0.05。试验组与对照组术后平均生存时间分别为48.0与40.8个月,中位生存期分别为53.0与42.0个月,差异有统计学意义,P<0.05。试验组术后局部复发和远处转移共37例,对照组共43例,差异有统计学意义,P<0.05;试验组复发转移者PCNA及MVD表达高于无复发转移者,差异有统计学意义,P<0.05。试验组生存时间≥36.0个月的患者化疗后PCNA及MVD表达明显下降,P<0.05。结论:结直肠癌动脉灌注新辅助化疗安全可行,能提高远期生存率;PCNA及MVD的检测可以作为动脉灌注新辅助化疗后远期疗效的客观评价指标。OBJECTIVE： To explore the effect of neoadjuvant chemotherapy via arterial infusion on survival rate and prognostic significance of PCNA, MVD in coloreetal carcinoma. METHODS： Totally 128 patients with stage Ⅱ B or Ⅲ colorectal carcinoma were divided into test group（68 cases, preoperative neoadjuvant chemotherapy via arterial infusion） and control group（60cases, received surgery directly） randomly. The espression of PCNA and MVD were examined by immunohistochemical SP method in 68 colorectal carcinoma samples of test group before neoadjuvant chemotherapy via arterial infusion and post-operation. The difference of survival rate of 1 , 3 , 5-years between two groups was analyzed. RESULTS： The 1-, 3 , 5-year survival rate of post operation was 95.3%, 85.9%, 44.6% in test group; 92. 6%, 75. 9%, 22.0% in control group respectively. There was significant difference on 5-year survival rate （P 〈 0.05 ）. The average survival time of the two groups was 48.0 （test group）, 40.8 （control group） months respectively; and the median survival time of the two groups was 53.0 and 42.0 months respectively. There was significant difference between them （P＇~0.05）. In the test group, 37 cases had recur and metastasis during the five years, meanwhile having 43 cases in contrast group（P〈0.05）. By neoadjuvant chemotherapy via arterial infusion, the expression of PCNA and MVD were decreased, and There was significant difference in patients that survival time exceeded 36 months （P〈0.05）. CONCLUSION： Neoadjuvant chemotherapy via arterial infusion is safe and feasible, it can improve the long term survival rate of colorectal and PCNA, MVD can be as a index for evaluating it＇s efficacy.

关 键 词：结肠直肠肿瘤/药物疗法 生存率 增殖细胞核抗原 微血管密度 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]