奥曲肽诱导胃癌术前腹腔化疗淋巴结内肿瘤细胞凋亡

Octreotide induces apoptosis of lymph node metastasis of gastric cancer before surgery

目的探讨临床行卡铂腹腔内化疗前加用奥曲肽对胃癌淋巴结转移灶癌细胞凋亡的影响。方法 40例胃癌伴淋巴结转移患者行胃癌根治性切除术。20例腹腔化疗前加用奥曲肽(0.1 gq8h.×3)为治疗组,另外20例未用奥曲肽作为对照组。用免疫组化ABC法检测淋巴转移灶p53蛋白(p53)、B细胞淋巴瘤-白血病2(Bcl-2)及Bcl相关X蛋白(Bax)基因表达,TUNEL法检测细胞凋亡。结果治疗组淋巴转移灶p53和Bax表达较对照组明显增强(P<0.05),并与细胞凋亡呈正相关;Bcl-2表达降低,并与细胞凋亡呈负相关。结论胃癌术前腹腔化疗前加用奥曲肽可能通过p53、Bcl-2及Bax介导使转移淋巴结癌细胞凋亡增加,有助于提高根治性手术的治疗效果。

Objective：To study the effects of octreotide before intraperitoneal chemotherapy and surgery on the apoptosis of lymph node metastasis in patients with gastric cancer.Methods：Forty gastric cancer patients with lymph node metastasis（group O） underwent redical resection after intraperitoneal chemotherapy at 3 h before surgery,of whom 20 patients were injected im.octreotide 0.1 g q8h started at 24 h before operation.The other 20 cases（group C） were not injected octreotide as the controls.The expressions of p53,Bax and Bcl-2 were examined by immunohistochemistry and cell apoptosis in the lymph node metastasis was examined by TUNEL method.Results：The expression intensity of p53 and Bax in the lymph node metastasis increased,but that of Bcl-2 decreased,significantly more in group O than that in group C.Conclusion：Octreotide given before intraperitoneal chemotherapy may induce the apoptosis of lymph node metastasis by regulating the expressions of p53,Bax and Bcl-2,which is benificial to improving the operative outcomes in gastric cancer patients with lymph node metastasis.