大肠癌术前化疗疗效的病理组织学对照研究

Histologic study on colorectal cancer with preoperative chemotherapy

目的探讨大肠癌术前化疗的方法及疗效．方法本院同期手术治疗的１１４例大肠癌病例，根据术前化疗方法分为：Ａ动脉灌注化疗组６２例；Ｂ静脉化疗组１９例；Ｃ５氟脲嘧啶（５ＦＵ）保留灌肠组１２例；Ｄ对照组２１例．化疗后２ｗｋ～４ｗｋ行肿瘤切除术，肿瘤标本做病理切片组织学疗效观察．结果Ａ，Ｂ，Ｃ组化疗后切除的肿瘤其细胞变性、坏死数量及程度均明显高于对照组（Ｐ＜００１），其中动脉灌注化疗组高于静脉化疗组和５ＦＵ保留灌肠组（Ｐ＜００５）．４０例使用５ＦＵ的动脉灌注化疗组中８例出现化学性肠炎，其中２例出现肠缺血坏死．结论大肠癌术前化疗以动脉灌注化疗疗效最好，应作为首选；５ＦＵ作为大肠癌术前动脉灌注化疗用药疗效不显著而副作用明显，应避免使用．

AIM To investigate the method and therapeutic effect of preoperative intra arterial infusion chemotherapy in colorectal cancer. METHODS The colorectal cancer patients ( n =114) were divided into 4 groups according to preoperative chemotherapy: A. intra arterial infusion chemotherapy (IAIC) group ( n =62); B. intravenous chemotherapy group ( n =19); C.5 fluorouracil retention enema group ( n =12); and D. control group ( n =21). The tumor of all cases were resected within 2-4 weeks after chemotherapy and histological examination of the resected specimens were performed to evaluatie the therapeutic effect. RESULTS The cell necrosis of tumor in the first three groups were more obvious than control group ( P <0 01), and group A was more obvious than group B or group C ( P <0 05). There were 8 cases of chemoenteritis (2 of them had intestinal necrosis) in the 40 cases used 5 FU in the IAIC. CONCLUSION Among the preoperative chemotherapies of the colorectal cancer, the most effective method is IAIC. 5 FU is not a significant drug in the IAIC.