肠外营养支持对结直肠癌患者细胞周期蛋白D1表达的影响

Effects of Total Parenteral Nutrition Support on Cyclin D1 of Colorectal Cancer Cells

目的探讨短期肠外营养支持对结直肠癌患者肿瘤细胞增殖、凋亡和细胞周期蛋白D1(cyclinD1)表达的影响。方法选择经病理诊断为结或直肠癌的患者60例,随机分成3组。A组:肠外营养组(TPN);B组:肠外营养+化疗组(TPN+CT)。C组:非营养支持组。A组患者给予由葡萄糖、脂肪乳剂、氨基酸及微量元素等组成的营养液肠外营养支持7天后实施结、直肠癌手术治疗。B组在肠外营养支持的同时,给予5-氟尿嘧啶(5-FU)15mg/(kg·d)静脉滴注7天后进行手术治疗。C组患者术前不进行营养支持。采用脱氧核苷酸末端转移酶(TdT)介导的x-dUTP缺口末端标记(TUNEL)技术、免疫组织化学方法和原位杂交检测cyclinD1的表达,分别测定各组病例在进行肠外营养支持或5-FU化疗前后肿瘤组织中肿瘤细胞的凋亡、增殖指数和cyclinD1表达水平。结果A组与C组相比,肿瘤细胞的增殖、凋亡指数及cyclinD1的表达差异均无显著性(P>0·05)。B组与A组相比,肿瘤细胞的增殖指数明显减少(P<0·05),肿瘤细胞的凋亡指数明显增高(P<0·05),cyclinD1表达差异无显著性(P>0·05)。结论短期肠外营养支持不会影响cyclinD1的表达,也不会促进肿瘤细胞增殖。营养支持配合5-FU化疗,可明显抑制肿瘤细胞的增殖、诱导肿瘤细胞的凋亡。

Objective To evaluate the effects of short-term total parental nutrition on the proliferation, apoptosis, and expression of cyclin D1 of colorectal cancer ceils. Methods Sixty patients with colorectal carcinoma were randomly divided three groups. In the group A, 20 patients were given total parenteral nutrition （TPN） （ which included glucose, intralipid, amino acid, and vitamins） for consecutive 7 days before the operation. In the group B, while received TPN, 20 patients received chemotherapy [ 5-Floxuridine was intravenously injected by 15rag/ （ kg·d） ] for consecutive 7 days before the operation. In the group C, the remaining 20 patients did not receive any nutrition support before the operation. The samples were gained by colonendoscopy or operation before and after operation. Terminal deoxynucleotidyl transferase-mediated nick end labeling （TUNEL） technique and proliferating cell nuclear antigen （PCNA） immunohistochemical staining were used to detect the proliferation, apoptosis, and the expression of cyclin D1 in the tissue of carcinoma. The apoptotic index （AI）,proliferating index （PI）, and expression of cyclin D1 were calculated before and after operation. Results In comparison with group C, there was no significant increase of PI, AI, and the expression of cyclin D1 in group Aafter TPN （P 〉 0. 05 ）. In group B, AI significantly increased and PI significantly decreased in comparison with group A （P 〈 0. 05 ） ; however, expression of cyclin D1 was not significantly different between group B and group A after TPN or PN ＋ CT （ P 〉 0.05 ）. Conclusion Although TPN may not promote proliferation and apoptosis of carcinoma cells, and may not disturb the expression of cyclin D1, it may effectively induce apoptosis and inhabit proliferation when combined with 5-Floxuridine chemotherapy.