术前肠外营养和化疗干预对结直肠癌细胞生物学的影响

The influence of preoperative enteral nutrition and chemotherapy on biological features of coloretal cancer

目的 了解术前短期肠外营养对大肠癌细胞增殖的影响。方法 治疗干预前经肠镜活检证实为大肠癌的患者,随机分为4组,即对照(CO),肠外营养组(PN),术前单纯化疗组(CT),肠外营养加化疗支持组(PT)。流式细胞计数仪检测手术取得标本的增殖情况:DNA指数;细胞周期GO/Gl、S、G2+M(％);Ki67免疫组织化学染色检测术前肠镜标本和手术取得标本的Ki67指数。采用SPSS8.0统计软件包进行统计处理。结果 经5～7天治疗后,PN组细胞增殖指标Ki67指数有显著增加;CT组则显著减少(P<0.01),治疗干预后的细胞生物学指标Ki67、S、G2+M各组间均有显著差异(P<0.05),其中PN组Ki67、S、G2+M明显增加,CT组明显G2+M减少而S增加,PT组G2+M减少。结论 术前短期肠外营养(5～7天)可能会刺激肿瘤的生长增殖,但亦可能有利于发挥周期特异性化疗药物的疗效。

Objectives:To evaluate the effect of the preoperative use of PN and chemotherapy on the cell proliferation of colorectal neoplasm. Methods:Fifty-eight cases of coloreclal patients are divided into four groups in random by the preoperative dealing:Control group(18 cases,normal oral intake), PN group(f6 cases,Parenteral nutrition) ,Chemotherapy group(14 cases,5-FU for 5 days preop-erative),PN and Chemotherapy group(10 cases).All for 5-7 days preoperative.We acquired DNA index,G0、G1 phase, S phase,G2 + M phase of surgical sample through FCM,measure the Ki67 of scope and surgical samples by immunohistochemical method.Results:After 5-7 days treatment,the indexes of cell progression different in different treatment group.After PN,S phase、G2 + M phase and Ki67 index increased(P<0.05).After chemotherapy G2+ M phase and Ki67 index decreased obviously. In chemotherapy group,the S phase increased evidently (P<0.01),but the G2 + M phase decreased (P<0.05). Conclusion:Preoperative short term (5-7 days)use PN can increase the cell proliferation,but it will do favor for using cell-cycle specific chemotherapy.