新辅助放化疗对直肠癌病人术后临床效果及预后研究  

Effect of neoadjuvant chemoradiotherapy on clinical effects and prognosis in postoperative patients with rectal cancer

作　　者：李兴[1] 马丽娜[2] 彭大为[1] 王美清[1] LI Xing;MA Li-na;PENG Da-wei;WANG Mei-qing(Department of Oncology,Haikou Hospital,Haikou Hainan 570208,China;Department of Neurology,Centnal South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou Hospital,Haikou Hainan 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院肿瘤化疗科,海南海口570208 [2]中南大学湘雅医学院附属海口医院神经内科,海南海口570208

出　　处：《蚌埠医学院学报》2019年第1期45-47,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨新辅助放化疗前后直肠癌病人肿瘤微血管密度(MVD)、增殖细胞核抗原(PCNA)及血管内皮生长因子(VEGF)的变化及其临床效果和对预后的影响。方法:选择行新辅助放化疗+手术切除的直肠癌病人96例为观察组,同期仅行手术切除的直肠癌病人86例为对照组,观察组病人采用术前新辅助放化疗:术前采用6 MV X线直线加速器进行常规分割放疗、化疗;新辅助放化疗结束后4～6周进行直肠癌根治性手术。观察组取未行新辅助放化疗前及行新辅助放化疗后手术切除标本进行MVD、PCNA及VEGF表达检测;对照组取手术前病检标本及手术切除标本进行MVD、PCNA及VEGF表达检测。比较2组病人手术前后MVD、PCNA及VEGF表达及临床效果与预后情况。记录3年随访统计复发率。结果:手术后,观察组病人MVD、PCNA表达显著降低,与对照组差异均有统计学意义(P<0.01);2组病人VEGF表达差异无统计学意义(P>0.05)。术后随访3年,对照组复发率为9.3%,观察组复发率为2.1%,2组差异无统计学意义(P>0.05)。结论:新辅助放化疗可以降低直肠癌病人MVD及PCNA表达。Objective:To investigate the effects of neoadjuvant chemoradiotherapy on the levels of microvessel density(MVD),proliferating cell nuclear antigen(PCNA)and vascular endothelial growth factor(VEGF)and prognosis in postoperative patients with rectal cancer.Methods:Ninety-six rectal cancer patients treated with neoadjuvant chemoradiotherapy combined with resection and 86 rectal cancer patients treated with surgical resection were divided into the observation group and control group,respectively.The observation group was treated with rectal cancer radical surgery after routine segmental radiotherapy using 6 MV X-ray linear accelerator combined with neoadjuvant chemoradiotherapy for 4 to 6 weeks.The levels of MVD,PCNA and VEGF in surgical specimens in observation group before and after neoadjuvant chemoradiotherapy were detected.The expression levels of MVD,PCNA and VEGF in control group before and after operation were detected.The expression levels of MVD,PCNA and VEGF,and prognosis between two groups were compared before and after operation.The recurrence rates in two groups during 3-year following up were recorded.Results:After operation,the expression levels of MVD and PCNA in observation group were significantly lower than those in control group(P<0.01).There was not statistical significance in VEGF expression between two groups(P>0.05).The recurrence rates in control group and observation group during 3-year following up were 9.3%and 2.1%,respectively,the difference of which was not statistically significant(P>0.05).Conclusions:Neoadjuvant chemoradiotherapy can decrease the expression levels of MVD and PCNA in rectal cancer patients.

关 键 词：直肠肿瘤 新辅助放化疗 肿瘤微血管密度 增殖细胞核抗原 血管内皮生长因子 

分 类 号：R735.37[医药卫生—肿瘤]