贲门腺癌化疗加静脉营养支持的细胞动力学研究  

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

作　　者：魏文杰[1] 刘建东[1] 才又红[2] 杨景国[1] 刘丽岩[2] 

机构地区：[1]北京市普仁医院,北京100062 [2]河北邯郸市第一医院,056000

出　　处：《临床肿瘤学杂志》2002年第5期341-344,共4页Chinese Clinical Oncology

摘　　要：目的 :应用细胞动力学方法 ,探讨短期静脉营养支持对晚期贲门腺癌化疗效果的影响。方法 :1997年 1月～1999年 10月 ,选择无法根治切除的晚期贲门腺癌患者 38例中男 2 2例、女 16例 ,中位年龄 5 4岁。Ⅲ期 2 5例 ,Ⅳ期 6例。将患者随机分为①营养组 (12例 )、②化疗组 (12例 )和③营养 +化疗组 (14例 )。营养配方 :氮 0 15·kg-1·d-1,非蛋白质热量2 0Kcal·kg-1·d-1,肠外营养支持平均 7天。联合化疗方案为 5 氟尿嘧啶、四氢叶酸钙、丝裂霉素和表阿霉素 ,2 8天为一周期 ,完成至少 2个周期。在治疗前后均进行胃镜检查 ,对肿瘤及正常胃粘膜的不同部位进行采样 ,经流式细胞仪测定 ,对照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 :治疗后肿瘤细胞S期和S +G2 +M期的百分数在营养组明显增高 (P分别 <0 0 1和 <0 0 5 ) ,营养 +化疗组显著下降 (P均 <0 0 0 1) ,化疗组无变化(P >0 0 5 ) ,各组正常胃粘膜在治疗前后无变化 (P >0 0 5 )。营养 +化疗组的化疗有效率明显高于化疗组 (P <0 0 5 )。结论 :短期静脉营养支持能提高患者的生活质量 ,刺激贲门腺癌细胞增殖的同时能增强贲门腺癌的化疗效果。Objective:To study the effect of short term parenteral support (PNS) plus chemotherapy (CT) on tumor cell kinetics.Methods:From Jan. 1997 to Oct. 1999, 38 patients with advanced gastric cardia cancer who enrolled in the study comprised of 22 men and 16 women, ranging in age from 38～68 yr (mean:54 yr). The cancer was classified as stage Ⅲ in 25 patients, stage Ⅳ in 6 patients (liver metastasis). The regimen of chemotherapy was 5 FU+CF+MMC+EPI(5 fluorouracil+Calcium folniate+Mitomycin C+Epirubine). The regimen of TPN was: total caloric value (NPC) 20 Kcal·kg -1 ·d -1 , nitrogen 0 15·kg -1 ·d -1 . The 38 cases were randomly divided into three groups. ①PNS, 12 cases;②CT, 12 cases;③PNS+CT, 14 cases. Specimen of gastric cardia cancer and normal gastric 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.Results:The tumor cell in S and proliferative phases were significantly increased after PNS ( P <0 01, P <0 05 respectively), but decreased after PNS+CT ( P <0 001). However no significant change was observed in single CT group and normal gastric mucosa cell ( P >0 05). The response rates increased higher significantly in group of PNS+CT than single CT ( P <0 05).Conclusion:PNS might enhance the effect of CT and improve the quality of life in gastric cardia cancer patients, probably by stimulation of tumor cell kinetics.

关 键 词：贲门腺癌 联合化疗 静脉营养支持 细胞动力学 治疗方法 DNA含量 细胞周期 毒性反应 

分 类 号：R735.2[医药卫生—肿瘤]