术前新辅助化疗对大肠癌组织Smad4表达的影响及其与细胞增殖凋亡的关系

The efect of preoperative neoadjuvant chemotherapy on the expression of Smad4 in colorectal carcinoma and its correlation with cell apoptosis and proliferation

目的探讨术前新辅助化疗对大肠癌Sm ad4表达的影响及其与细胞增殖凋亡的关系。方法应用免疫组化S-P技术及原位末端标记法(TUNEL法)对15例经术前新辅助化疗的患者进展期大肠癌标本进行Sm ad4、增殖细胞核抗原(PCNA)、细胞凋亡的检测,并以18例经5-FU静脉化疗及21例未经化疗进展期大肠癌作为对照。结果在3组中Sm ad4的表达呈递增趋势(P<0.05);在3组中PCNA的表达呈递减趋势(P<0.05);凋亡指数(AI)在3组中也呈递增(P<0.05)。从未经化疗的空白对照组→5-FU化疗组→新辅助化疗组,Sm ad4与AI呈正相关(r=1,P<0.01),与PCNA呈负相关(r=-1,P<0.01)。结论术前新辅助化疗可使进展期大肠癌组织中Sm ad4表达更为明显增高,并可更有效的抑制大肠癌细胞增殖促进凋亡,术前新辅助化疗可作为比5-FU静脉化疗更为有效的一种治疗进展期大肠癌的辅助化疗手段。

Objective To discuss the efect of preoperative neoadjuvant chemotherapy on the expression of Smad4 in colorectal carcinoma and its correlation with cell apoptosis and proliferation.Methods 15 evolutional Colorectal Carcinoma cases were treated with preoperative neoadjuvant chemotherapy and 18 cases with 5-FU chemotherapy、21 cases with operation served as the control group.The expressions of Smad4 and proliferating cell nuclear antigen（PCNA） were detected by Immunohistochemic S-P method,and cell apoptosis was measured by TUNEL.Results Among the three group,the expression level of Smad4 gradually increased（P0.05）;the expression level of AI gradually increased too（P0.05）;the expression level of PCNA gradually decreased（P0.05）.From operation group to preoperative neoadjuvant chemotherapy group,Smad4 expression level was positively correlated with AI（r= 1,P0.01）,and the negative correlation between Smad4 expression level and PCNA was observed（r=-1,P0.01）.Conclusion Preoperative neoadjuvant chemotherapy could induce cell apoptosis and the expression level of Smad4 and inhibit the cell proliferation in colorectal carcinoma,so it could be an effective accessorial chemotherapy method than 5-FU chemotherapy.