静脉营养支持对晚期直肠癌化疗效果的影响  

Effects of short term parenteral nutrition support with chemotherapy on tumor cell kinetics in rectal cancer patients

作　　者：刘建东[1] 才又红[1] 

机构地区：[1]河北省邯郸市第一医院外科,056002

出　　处：《中华普通外科杂志》2000年第7期405-407,共3页Chinese Journal of General Surgery

摘　　要：目的　应用细胞动力学方法 ,研究短期静脉营养支持对晚期直肠癌化疗效果的影响。方法　将无法根治切除或复发的晚期直肠癌患者 32例随机分为①营养组 (10例 )、②化疗组 (10例 )和③营养 +化疗组 (12例 ) ,分析三组的癌细胞和正常细胞DNA含量、倍体类型及细胞周期各时相比例 ,比较组间的化疗有效率。结果　营养组治疗后肿瘤细胞S期和S +G2 +M期的百分数明显增高(分别为t=5 5 41,P <0 0 0 1和t=3 338,P <0 0 1) ,营养 +化疗组显著下降 (分别为t=4 86 4,P <0 0 0 1和t=5 749,P <0 0 0 1) ,化疗组无变化 (分别为t=1 2 6 8,P >0 0 5和t=1 2 0 2 ,P >0 0 5 ) ,各组正常直肠粘膜在治疗前后无变化 (t值均小于 2 2 0 1,P均 >0 0 5 )。营养 +化疗组与化疗组比较 ,前者的化疗有效率明显升高 (χ2 =7 47,P <0 0 5 ) ,而毒性反应发生率明显减少 (χ2 =6 6 7,P <0 0 5 )。结论　单纯的短期静脉营养支持能刺激直肠癌细胞增殖 ,对正常直肠粘膜无影响 ;Objective To study the effect of short term parenteral support (PNS) plus chemotherapy (CT) on tumor cell kinetics.[WT5”HZ] Methods[WT5”BZ] 32 cases of late staged rectal carcinoma were randomly divided into three groups. ① PNS, 10 cases; ② CT, 10 cases; ③ PNS+CT, 12 cases. Specimen of rectal cancer and normal rectal mucosa were taken before and after PNS or/and CT in all the patients. All specimens were studied by flow cytometry for cell cycle analysis,such as DNA content and DNA index etc.[WT5”HZ] Results[WT5”BZ] The tumor cell in S and proliferative phases significantly increased after PNS( t =5 541, P <0 001; t =3 338, P <0 01 respectively), but decreased after PNS+CT ( t =4 864, P <0 001; t =5 749, P <0 001 respectively).No significant change was observed in CT group ( t =1 268, P >0 05; t =1 202, P >0 05,respectively) and normal rectal mucosa cell ( t <2 201, P >0 05 in every group). The response rates increased significantly in group of PNS+CT than that of CT(χ 2=7 47, P <0 05),the toxicity rates was significantly higher in group of CT than that of PNS+CT(χ 2=6 67, P <0 05).[WT5”HZ] Conclusion[WT5”BZ] PNS+CT might enhance the effect of CT and improve the quality of life in rectal cancer patients.

关 键 词：直肠肿瘤 胃肠外营养 药物疗法 

分 类 号：R735.37[医药卫生—肿瘤]