中晚期胃癌术前插管化疗后癌细胞凋亡和增殖的变化

Effects of preoperative chemotherapy(intra-arterial infusion) on apoptosis and cellular proliferation of advanced gastric cancer

目的探讨术前腹腔动脉灌注化疗对中晚期胃癌细胞凋亡和增殖的影响。方法采用原位末端标记法(TUNEL)、增殖细胞核抗原(PCNA)和凋亡抑制蛋白(Bc l-2)免疫组化检测技术,观察比较术前腹腔动脉灌注化疗组(31例)和未化疗手术组(32例)中晚期胃癌标本的凋亡指数、增殖指数和Bc l-2蛋白表达强度的差异。结果术前化疗组凋亡指数明显高于对照组(P<0.01),增殖指数明显降低(P<0.01),Bc l-2蛋白表达强度明显低于对照组(P<0.01)。凋亡指数与Bc l-2分值呈负相关(P<0.01),凋亡指数与增殖指数呈正相关(P<0.05)。治疗组治愈性切除率明显高于对照组(P<0.01),3年生存率高于对照组(P<0.05)。结论术前腹腔动脉插管化疗可诱导中晚期胃癌细胞凋亡,降低肿瘤细胞的增殖活力,提高治愈性切除率,改善患者生存率。诱导胃癌细胞凋亡可能与化疗药物降低Bc l-2基因蛋白的表达有关。

Objective To observe the effects of preoperative chemotherapy on apoptosis and cellular proliferation on gastric cancer in advanced stage, and to evaluate the significance of being taken as a prognostic marker. Methods Terminal deoxynucleotidyl transferase- mediated duTP nick-ond labeling（TUNEL）and immunohistochemical method were, applied to detect the difference of apoptosis index（ AI）, Bcl -2 and proliferation cell nuclear antigen （PCNA） indices in 63 cases of gastric cancer in advanced stage. Thirty one cases treated by preoperative chemotherapy and other 32 cases without preoperative therapy as control. Results The apoptosis index in the group treated by preoperative chemotherapy was higher than that in control group（ P 〈 0. 01 ） ,but lower the proliferation index（PI） and the value of Bcl -2 protein. The three years survival rate in treaten group was detected by degree relative analysis（ rR = 0. 743, P 〈 0. 01 ） ,The three years survival rate in treated group was higher than that in control group（ P 〈 0. 05 ）. Conclusion The application of preoperative chemotherapy for gastric cancer patient may decrease Bcl -2 protein expression and induce cancer cells apoptosis of gastric cancer cells. Preoperative chemotherapy is benefit for improving the survival rate of the patients.