直肠癌淋巴结转移的RERC、PVC疗效对比观察

Comparison between regional extended release chemotherapy and persistently intravenous chemotherapy effect to rectal cancer lymph nodes metastasis

目的比较区域缓释化疗(RERC)和持续静脉化疗(PVC)治疗直肠癌淋巴结转移的效果。方法60例直肠癌患者,均有淋巴结转移,行手术治疗。随机分为对照组、RERC组和PVC组,各20例。对照组直接手术不进行化疗;RERC组于术前48h在瘤周黏膜下点状植入含5-FU的区域缓释剂;PVC组术前48h经静脉化疗泵持续泵入5-FU。术中取三组患者肠上、肠旁淋巴结(第1站),肠系膜血管旁淋巴结(第2站)和血管根部淋巴结(第3站),检测并比较淋巴结内癌细胞增殖指数(PI)、凋亡指数(AI)及凋亡指数/增殖指数(AI/PI)。结果RERC组第1、2站淋巴结内转移肿瘤细胞PI、AI、AI/PI与其他组对应站别相比P均<0.05;第3站与该组前两站和PVC组该站别相比P均<0.05,但与对照组对应站别比较P>0.05。对淋巴结转移肿瘤细胞抑制作用由强到弱依次为RERC组第1站、第2站、PVC组第1站、第2站、第3站、RERC组第3站。结论RERC治疗直肠癌淋巴结转移疗效优于PVC,但作用范围局限,需多点植入。

Objective To Compare the treatment effect of rectal cancer lymph nodes metastasis between regional extended release chemotherapy （RERC） and persistently intravenous chemotherapy （PVC）. Methods It was removed respectively that the lymph nodes at or beside colon, beside and at the root of mesentery blood vessel of the patients with rectal cancer belong to the control group, RERC group and PvC group. And the aim is to compare PI, AI and AI/PI of cancer cell in the lymph nodes. Results To compare PI , AI and AI/PI of metastatic cancer cell ：in lymph nodes, There are significantly correlations on at or beside colon and beside of mesentery blood vessel between RERC group with anyone of others groups（P 〈 0. 05） ; In RERC group there were also significantly correlations between at the root of mesentery blood vessel with anyone of those at or beside colon and beside of mesentery blood vessel（ P 〈 0. 05 ）. Yet there were no significantly correlation at the root of mesentery blood vessel between RERC group and the control group（P 〉 0. 05 ）： Sorted by the treatment effect of cancer cell in lymph nodes was the first then the second station of RERC group , then any station of PVC group, and the last is the third station of RERC group which was almostly equal to any station of control group. Conclusions Compared with PVC, RERC presented can get ideal effect. And to compensate the limited effective scale, it Should be planted in multiple of sites.