低位直肠癌腔内热疗加放疗后临床病理学改变

Clinicopathological Changes in Lower Rectal Cancer After Preoperative Endocavitary Hyperthermia Combined with Radiation

[目的]探讨术前腔内热疗(preoperative endocavitary hyperthermia,PEH)加放疗对低位直肠癌临床病理学改变的影响。[方法]将72例低位直肠癌患者分为3组:A组30例接受术前腔内热疗加放疗,B组15例单纯放疗,C组27例未行热疗及放疗。观察3组病人治疗前和治疗后的临床表现,肿瘤大体病理改变、光镜改变及电镜改变。[结果]A组病人治疗后临床症状明显缓解;肿瘤缩小、疤痕化明显,边缘与正常组织分界清楚;光镜观察癌细胞变性、坏死、炎性细胞浸润明显;电镜观察癌细胞核破坏明显,有大量的凋亡细胞和凋亡小体。B组病人临床症状部分缓解;光镜和电镜下变化轻微;C组病人症状无改善,光镜及电镜观察无变化。[结论]PEH加放疗能明显改善低位直肠癌患者的临床症状,明显促进低位直肠癌病理改变。

[Purpose] To explore the clinicopathological changes in lower rectal cancer after preoperative endocavitary hyperthermia （PEH） combined with radiation. [Methods ] Seventy-two cases with lower rectal cancer were divided into 3 groups： 30 cases in group A treated with PEH combined with radiation; 15 cases in group B treated with preoperative radiotherapy alone; 27 cases in group C surgery alone. The symptoms were recorded and the histopathological changes were evaluated with optical and electron microscopy before and after treatment. [Results ] In group A, symptoms after treatment were alleviated obviously; tumor size reduced significantly; denaturalization and necrosis increased significantly under optical microscopy; and nucleus damage and cells opoptosis and bodies increased significantly under electron microscopy. In group B, symptoms alleviated partialy after treatment; pathology changes slightly. While in group C, there were no symptomatic and histopathological changes. [Conclusion] PEH combined with radiotherapy can obviously alleviates patients＇ symptoms, and promotes the histopathological changes in lower rectal cancer.