5-氟尿嘧啶在胰十二指肠切除术患者血液和胰液中的动态分布

Effect of preoperative chemotherapy on apoptosis and tissues of pancreatic adenocarcinoma

目的探讨５氟尿嘧啶能否通过胰十二指肠切除术后的残留胰腺组织进入胰液中，并达有效的治疗浓度，为胰腺癌临床合理化疗提供理论依据。方法通过观察胰十二指肠切除术患者静脉快速推注５氟尿嘧啶后血液和胰液中药物动态分布及相关性，术后静脉一次性快速推注５氟尿嘧啶１０ｇ／ｍ２，在给药前后按设计时间点分别采集静脉血和胰液，采用高效液相色谱法测定血浆和胰液中５氟尿嘧啶药物浓度，应用ＰＣＮＯＮＬＩＮ程序计算其动态穿透比。结果５氟尿嘧啶静脉快速推注后能很容易地穿透胰十二指肠切除术后残留的胰腺组织进入胰液，穿透比平均为１０１±０４９，胰液中药物浓度明显高于同期血药浓度，并呈同步消除。结论５氟尿嘧啶适用于胰腺癌患者胰十二指肠切除术后的辅助化疗。

Objective To investigate the apoptosis and tissues change of pancreatic adenocarcinoma with or without preoperative chemotherapy and discuss the effect of preoperative regional chemotherapy on pancreatic adenocarcinoma cell. Methods Using the method of TUNEL and microscope, we determined the apoptosis of tumor cells and tissues changes in 30 pancreatic adenocarcinoma patients with or without preoperative chemotherapy. Results The ratio of apoptosis was much higher in the preoperatively treated group than in the untreated group(44 87±27 78) and (3 6±3 76)/HP,( P <0 01). The ratio of apoptosis was related to the tissue type of pancreatic adenocarcinoma. The ratio of apoptosis in the highly differentiated adenocarcinoma group was much higher than that in the middle or low differentiated adenocarcinoma group( P <0 05, P <0 01). The inflammatory reaction and the proliferous intima of vessels were more dvious in the preoperatively treated group than in the untreated group( P <0 05, P <0 01). Conclusions Preoperative regional chemotherapy can effectively inhibit pancreatic adenocarcinoma by inducing the apoptosis of tumor cells.