新辅助化疗降低食管癌微转移的研究

Role of Neo-adjuvant Chemotherapy in Reduction of Micrometastasis of Esophageal Squamous Cell Carcinoma

目的通过术前应用奥沙利铂,氟尿嘧啶和亚叶酸钙,术后行淋巴结微转移检测,了解新辅助化疗在降低微转移中的作用。方法80例食管癌患者随机分为单纯手术组、新辅助化疗组,每组40例。新辅助化疗组术前给与奥沙利铂,氟尿嘧啶和亚叶酸钙,2周为一周期,完成两周期后在全麻下行左开胸食管部分切除食管胃颈部吻合术,并清扫区域淋巴结。HE染色"阴性淋巴结"做免疫组织化学染色。结果新辅助化疗组CK(AE1/AE3)单克隆抗体阳性反应淋巴结数明显少于单纯手术组,差异有统计学意义。结论新辅助化疗组术前化疗方案,可以有效降低微转移。

Objective To evaluate the value of Neo-adjuvant chemotherapy in the reduction of micrometastasis of esophageal squamous cell carcinoma. Methods Eighty cases of esophageal squamous cell carcino ma were randomly divided into two groups： （1） surgery group and （2） Neo-adjuvant chemotherapy group：Oxaliplatin, Fluorouracil and Leucovorin were used before operation. Two hundred and forty seven lymph nodes were negative by HE staining negative with thoracic esophageal squamous cell carcinoma and examined by immunohistoehemical method using the monoclonal antibody AE1/AE3 to define histologically undetectable micrometastasis. Results AE1/AE3-positive lymph node metastases were significantly decreased in Neo-adjuvant chemotherapy group than that in surgery group. Conclusion Neo-adjuvant chemotherapy is effective in reduction of micrometastasis in esophageal squamous cell carcinoma.