术前膀胱药物灌注降低膀胱癌手术切口种植转移率的实验研究  

Experimental research of the reduction of bladder cancer implantation metastasis incidence in operative incision by preoperative drug perfusion

作　　者：何兵[1] 郑少斌[1] 陈响秋 钟缔 张辉见[1] 

机构地区：[1]南方医科大学附属南方医院泌尿外科,广东广州510515

出　　处：《暨南大学学报（自然科学与医学版）》2015年第4期330-334,共5页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：广东省自然科学基金项目(S2011010003764)

摘　　要：目的:探讨膀胱癌术前药物保留灌注膀胱降低手术切口膀胱癌种植转移率的有效性及其可能机制.方法:构建大鼠膀胱癌模型,分别获取药物处理后及生理盐水处理后的定量膀胱肿瘤组织.取部分两组处理后组织进行流式细胞仪检测,观察两组处理后肿瘤组织细胞凋亡率.健康SD大鼠60只随机分为实验组及对照组,实验组大鼠腹壁切口种植药物处理后的肿瘤组织,对照组种植生理盐水处理后的肿瘤组织,种植后观察两组在不同时间段成瘤情况及是否可以减少膀胱癌组织在手术切口处的种植转移率.结果:种植后不同时间段切口出现可触摸肿物的实验组及对照组的大鼠例数,2周后分别为1只(3.3%)和4只(13.3%),3周后分别为4只(13.3%)和10只(33.3%),4周后分别为5只(16.6%)和16只(53.3%),观察至第6周,未再见新增转移大鼠.种植后实验组及对照组的大鼠切口肿物直径平均大小,2周后分别为0.3 cm和0.45 cm,3周后分别为0.65 cm和1.25 cm,4周后分别为1.05 cm和1.87 cm,6周后分别为1.56 cm和2.45 cm.实验组及对照组处理后肿物组织细胞凋亡率分别为:(36.67±1.63)%,(9.23±1.03)%.结论:在大鼠膀胱癌切口种植转移模型中,膀胱药物保留灌注后的肿瘤组织有较低的种植转移率.抗肿瘤药物的膀胱灌注对肿瘤的细胞及组织有杀灭作用,减少了具有转移能力的肿瘤细胞及组织的数量.Aim: To explore the effectiveness and mechanism of bladder preoperative drug perfusion to reduce the bladder cancer implantation metastasis incidence in operative incision. Methods: Equivalent epirubicin treated tumor tissues and saline treated tumor tissues were obtained from the rat model with bladder cancer. Subsequently,equivalent tumor tissues were obtained from the two groups and analyzed by flow cytometry to measure the apoptosis effect. 60 healthy SD rats were randomly divided into 2 groups as treatment and control groups,which were inoculated with drug treated tumor tissues and saline treated tumor tissues in abdominal incision respectively. We examined the tumor growth in different stages and the implantation metastasis in operative incision. Results: We observed that 1 treated rats and 4 controlrats had tangible tumor after two weeks,4 treated rats and 10 control rats had tangible tumor after three weeks and 5 treated rats and 16 control rats grew tangible tumor after four weeks. No rat growing tangible tumor after 6 weeks. Furthermore,we examined that the average diameter of tumor in treated rats and control rats were 0. 3 cm and 0. 45 cm( after two weeks),0. 65 cm and 1. 25 cm( after three weeks),1. 05 cm and 1. 87 cm( after four weeks),1. 56 cm and 2. 45 cm( after six weeks),respectively. Additionally,we found that preoperative single intravesical chemotherapy instillations induced 36. 67 ± 1. 63%apoptotic cells as compared with the control( 9. 23 ± 1. 03% apoptotic cells). Conclusion: The present study showed that the preoperative single intravesical chemotherapy instillations decrease the incision implantation metastasis by a way of inducing apoptosis.

关 键 词：膀胱肿瘤 膀胱内灌注 切口种植转移 

分 类 号：R473.6[医药卫生—护理学] R737.14[医药卫生—临床医学]