卵巢癌腹腔内化疗对腹膜后淋巴结的作用初探

The Effect of Intraperitoneal Chemotherapy on Retroperitoneal Lymph Node Metastasis of Ovarian Cancer

为探讨腹腔内给药治疗对腹膜后淋巴结的影响，采用顺铂腹腔内小剂量短期重复给药方式，观察30例卵巢癌患者术前48小时腹腔内化疗（单次注药组，15例）及术前96小时，48小时腹腔内化疗（重复注药组，15例）后，腹膜后淋巴结，周围结缔组织及腹膜中顺铂的浓度。结果显示，单次注药组和重复注药组腹膜后淋巴结内药物浓度是周围结缔组织的2．06倍和1．91倍，差异有高度显著性（P＜0．005）。单次和重复往药组腹膜中顺铂浓度分别是淋巴结的4．14和2．5倍，差异有高度显著性（P＜0．005）。重复给药组髂、闭孔、腹主淋巴结药物浓度是单次给药组的2．27倍、2．75倍、2．54倍，差异也有高度显著性（P＜0．005）。光镜下可见，重复给药组淋巴结内转移的癌组织出现液化性坏死，单次给药组仅见淋巴结有反应性增生。提示，顺铂腹腔内小剂量短期重复给药，可达药物积累效应，从而产生高效低毒结果，有可能成为治疗卵巢癌淋巴结转移的方法之一。

The objective of this study was to investigate the effect of intraperitoneal chemotherapy(repeated injections of cisplatin in small doses during a short time) on retroperitoneal lymph node metastasis of ovarian cancer. Thirty patients with ovarian cancer were selected and divided into two groups. The patients in the first group received intraperitoneal chemotherapy only once (48 hours before operation); the patients in the second group received intraperitoneal chernotherapy twice (96 hours and 48 hours before operation ). After the intraperitoneal chernotherapy, according to the predicted time, the Pt concentrations of the tissues were measured by flameless atomic absorption spectrometry; the pathologic examinations of the lymph nodes were carried out.The results showed that the drug concentrations of the aortic, obturator and iliac lymph nodes of the first group were not significantly different, neither were the drug concentrations of the lymph nodes of the second group. The drug concentrations of the lymph nodes of the first and the second groups were 2. 06 and 1. 91 times that of the surrounding tissues respectively. Also, the drug concentrations of peritoneum of the first and the second groups were 4. 14 and 2. 50 times that of the lymph nodes. The drug concentrations of the iliac, obturator and aortic lyrnph nodes of the second group were 2. 27, 2. 75 and 2. 54 times that of the first group (P<0. 005). Under light microscope, the metastasic cancer tissues in lymph nodes showed liquefaction necrosis in the second group. The results indicate that small doses of cisplatin given by repeated injections during a short time can lead to drug accumulation and consequently high efficacy with low toxicity, suggesting that this method may be used for the treatment of lyrnphatic metastasis of ovarian cancer.