盆腔腹膜外化疗法用于妇科恶性肿瘤淋巴系转移的初步研究

Chemotherapy against lymphatic metastases of gynecologic cancer via pelvic retroperitoneal cannulation:a preliminary report

通过动物实验及临床研究，对经盆腔腹膜外间隙穿刺插管进行化疗的可行性及其对妇科恶性肿瘤淋巴系转移的疗效进行探讨。动物实验结果表明，于盆腔腹膜外间隙注入５－氟脲嘧啶（５－ＦＵ）及伊索显（Ｉｓｏｖｉｓｔ－３００）混合剂后，注药部位局部细胞形态无改变，仅有少量淋巴细胞浸润；临床观察结果表明，（１）注药后Ｘ线摄片，可见髂外、髂内、闭孔、腹股沟深及大部分髂总淋巴结所在位置均包括在药物分布范围之内，重复给药，药物分布范围不变；（２）注药后４８小时内，注药侧淋巴结内、ＦＵ浓度高于对照侧，差异有极显著性（Ｐ＜０．０１）。腹主动脉旁淋巴结内５－ＦＵ浓度介于注药侧与对照侧淋巴结内浓度之间；（３）对己有肿瘤细胞转移的淋巴结，注药后显微镜下可见淋巴结内转移的癌细胞有明显变性、坏死；（４）本组患者未发生并发症及明显的全身毒副作用，本研究结果提示，经盆腔腹膜外间隙化疗是一种简便、安全、效果可靠的化疗方法。

ymphatic metastasis is one of the most iniportant probltems in the treatrnent of gynecologic malig-nancy.We conducted a preliminary investigation on the feaxibility and practicality of chemotherapy a-gainst lyrnphatic metastases of gynecologic cancer via pelvic retroperitoneal cannulation.5-FU mixed with Isovist-300 was injected into the pelvic retroperitoneal space.X-ray films revealed that the external iliac,hypogastric,obturator,deep inguinal and most of the cornmon iliac lyrnph nodes were submerged in the 5-FU solution.5-FU concentrations in the lymph nodes were measured by high pressure liquid chromatography,which showed that 5-FU concentration of the study group was 2 to 10 times that of the control group.Pathologic findings revealed that most of the metastatic cancer cells in the study group showed obvious degeneration and necrosis while no changes were observed in the control group.No major complications or adverse effects were observed.Our results suggest that this method may be used to treat the lymphatic metastases of gynecologic cancer.