结直肠癌肝转移临床与实验的防治研究  

Prevention and treatment for liver metastasis of colorectal carcinoma

作　　者：倪启超[1] 张春辉[1] 樊勇[1] 王华[1] 沈洪薰[1] 尤其俋[1] 陈玉泉[1] 

机构地区：[1]南通医学院附属医院普外科,南通226001

出　　处：《南通医学院学报》2004年第1期5-8,共4页ACTA Academiae Medicinae Nantong

摘　　要：目的 :降低结直肠癌根治术后肝转移发生率 ,提高结直肠癌根治术的疗效。方法 :(1)实验研究 :经脾脏注入 L s174 t细胞株脾切除法 ,建立人结肠腺癌 L s174 t细胞株接种裸鼠肝转移模型 ;检测实验组和对照组裸鼠肝转移癌灶数目、癌重及癌重 /肝重和肝转移组织中 nm 2 3- H1 表达。 (2 )临床研究观察组为结直肠癌根治术 +门静脉插管化疗4 8例 ,其中长期服用中药 5例 ;对照组为结直肠癌根治术 4 6例 ,比较术后肝转移发生率和生存率。结果 :(1)观察组裸鼠实验前后体重增长值 (4 .12± 0 .5 3g)明显高于对照组 (3.2 1± 0 .5 9g) ,P<0 .0 5。实验组裸鼠肝转移癌结节的数目 (2 .4 2± 0 .99个 )、癌重 (6 3.6 7± 2 1.2 9m g)及癌重 /肝重 (8.9%± 3.1% )均明显低于对照组 (4 .17± 1.99个 ) ,(94 .32± 37.86 m g)及 (13.2 %± 5 .3% ) ,P<0 .0 5。观察组裸鼠肝转移 nm2 3- H1 - NDPK阳性表达率为 6 6 .6 7%明显高于对照组16 .6 7% ,P<0 .0 5。 (2 )观察组结直肠癌根治术后肝转移发生率 12 .5 0 % ,明显低于对照组 34.78% (P<0 .0 5 )。观察组结肠癌根治术后 3、5年生存率分别为 87.5 0 %和 79.17% ,明显高于对照组的 6 7.39% ,5 2 .17% (P<0 .0 5 )。结论 :根治性切除结直肠癌是主要的防治方法 ;门静脉插管化?Objective:To decrease colorectal liver metastasis and to improve survival after curative resection of colorectal carcinoma.Methods:(1)Liver metastasis were established by intraspleen injection of colonic adenocarcinoma cells (Ls174t) with 1×10 6 cells in 0.1ml solution in 24 BALB/nude mice which were divided into two groups randomly. In both experimental group and control group,the weight,the size and the number of the liver metastases were studied;Every carcinoma nude were weighed;Specimens were fixed by formalin and embedded by paraffin;All slices with a thickness of 4mm were studied histologically.The expression of nm23H-NDPK in 24 nude mice with liver metastases from colon carcinoma was examined immunohistochemiscally(SP) by using antinm23.(2)94 patients who had curative resection of colorectal carcinoma were divided into therapeutic group (48 patients )and control group (46 patients )randomly at our hospital between 1994 and 1996.In therapeutic group,48 patients received intraportal infusion of 5-fluorouracil (1g per day x7),5 of them also received administration of compound Sheugitang.In control group,46 patients were treated with curative resection of colorectal carcinoma alone.Result:(1)The pathological results showed poorly differentiated human colonic adenocarcinoma.In experimental group the growth weight (4.12±0.53g) was significantly higher than that (3.21±0.59g)in control group (P<0.05).In experimental group the number (2.42±0.99n)and the weight (63.67±21.29mg)of liver metastases were significantly lower than those (4.17±1.99n and 94.32±37.86mg)in control group(P<0.05).In experimental group nm23H-NDPK positive expression rate (66.67%)was significantly higher than that (16.67%)in control group(P<0.05).(2)In therapeutic group ,postoperative liver metastasis rate 12.5% was significantly lower than that 34.78% in control group.In therapeutic group,3-year survival (87.50%) and 5-years survival (79.17%) were significantly higher than those (67.39%,52.17%and 47.62%)in control group(P<0.05).Conc

关 键 词：结直肠癌 转移性肝癌 裸鼠 门静脉插管化疗 人参 参三七 

分 类 号：R735.35[医药卫生—肿瘤]