新辅助化疗后开腹与腹腔镜手术治疗直肠癌近期、远期疗效研究  

Effect of Dickkopf-3 overexpression on the biological behavior of LoVo cells in colorectal cancer

作　　者：邓润枢[1] 莫林耀[1] 何锡华[1] 陈建华[1] 吴志明[1] 郭裕良 卢焕全[1] 叶镇彭[1] 黄兆伦[1] 卢星照[1] 

机构地区：[1]东莞市人民医院肿瘤外科,广东东莞523059

出　　处：《结直肠肛门外科》2015年第6期406-410,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的比较新辅助化疗后开腹与腹腔镜手术治疗直肠癌的近期、远期疗效。方法选取2005年1月至2012年8月我院收治的186例直肠癌患者作为研究对象,按完全双盲法分为对照组与观察组,均为93例。两组术前均采用新辅助化疗干预,对照组接受开腹手术,观察组则采用腹腔镜手术治疗,比较两组手术情况及治疗效果,两组均为期3年随访调查,评估其远期疗效。结果观察组患者术中出血量、首次肛门排气时间及住院时间分别为(104.39±38.46)m L、(1.28±0.81)d、(11.94±3.21)d,与对照组相比差异有统计学意义(P<0.05),但观察组手术时间长于对照组,对照组淋巴结清扫数目为(15.52±4.98)枚,与观察组对比差异有统计学意义(P<0.05);观察组术后切口感染、肺部感染发生率分别为3.23%、0,均低于对照组,其尿路感染、吻合口漏、出血及尿潴留等并发症发生率稍低于对照组,但对比差异无统计学意义(P>0.05);术后3年,观察组生存率为80.65%,低于对照组的92.47%,对比差异有统计学意义(P<0.05),观察组局部复发率为9.68%,高于对照组的2.15%,对比差异有统计学意义(P<0.05)。结论新辅助化疗联合腹腔镜手术可改善直肠癌患者近期疗效,整体效果与开腹手术相当,但开腹手术淋巴结清扫更彻底,患者远期生存率更高。Objective We used gene overexpression technology tooverexpress DKK-3 gene in CRC cells and to detect the changes of invasion and metastasis ability of CRC cells by using the method of migration assay and invasion assay.Methods Overexpression of DKK-3 induced by p EGFP-N1-DKK-3-GFP plasmid in Lo Vo cells was performed using Lipofectamine 2000 reagent.Construction,sequencing and identification of the plasmid were completed by SHANGHAI GENECHEM CO.,LTD.RT-PCR and Western Blotting were performed to determine the m RNA and protein expression levels of DKK-3,respectively.The cellular proliferation ability of transfected cells was measured via WST-8 assay.Cell cycle was analyzed on a FACSCalibur flow cytometer.Cell migration assay and tumour invasion assay were carried out by transwell chambers following the manufacturer's instructions.Caspase-3,caspase-9,Bax,Bcl-2,cytochrome c(Cyt-c) and β-catenin were measured by Western Blotting.Results PEGFP-N1-DKK-3-GFP mediated overexpression of DKK-3 significantly inhibited the proliferation of Lo Vo cells(P < 0.05),but there was no significant difference in the proliferation rate between Lo Vo and p EGFPN1(P >0.05).The number of cells in the p EGFP-N1-DKK-3 group was significantly less than that in the untreated Lo Vo group(P <0.05),indicating thatthe expression of DKK-3 might inhibit the invasion of Lo Vo cells.The number of cells in the p EGFP-N1-DKK-3 group was significantly less than that in the untreated Lo Vo and p EGFP-N1 groups(P < 0.05),indicating that DKK-3 overexpression may inhibit the migration of Lo Vo cells.Compared with untreated Lo Vo group and p EGFP-N1 group,the difference of G0/G1 phase cells in p EGFP-N1-DKK-3 group was statistically significant(P <0.05).The apoptosis of Lo Vo cells was also induced by DKK-3,which was manifested by caspase-9,Cyt-c,and protein expression,surviving,and Bax protein expression and activation of Bcl-2 and caspase-3.In addition,overexpression of DKK-3 also decreased the accumulation of beta-catenin in the cells.Conclusions DKK-3

关 键 词：直肠癌 新辅助化疗 腹腔镜 开腹手术 

分 类 号：R735.37[医药卫生—肿瘤]