大肠癌血管造影与介入化疗疗效的病理组织学对照研究

Histological comparative study of DSA and intraarterial perfusion in colorectal cancer

目的 :用病理组织学对照观察探讨大肠癌数字血管造影 ( DSA)表现和介入化疗 ( TAC)疗效及其相互之间的关系。 资料与方法 :96例大肠癌病例经术前 DSA及 TAC,2～ 4周后行肿瘤手术切除 ,与 40例单纯手术切除病例进行病理组织学对照观察。 结果 :DSA检查示大肠癌肿瘤血管染色发生率 ( 5 5 /96 )占 5 7.3% ,肿瘤血管染色发生率与肿瘤的恶性程度、侵犯深度及肿瘤大小呈正相关。介入化疗组细胞坏死、间质改变及血管内膜炎的发生率及严重程度明显高于对照组。造影中肿瘤血管染色的发生率与血管内膜炎的发生率有显著差异 ,而与细胞坏死的程度差异不显著。 结论 :DSA可以帮助判断大肠肿瘤的恶性程度、侵犯深度及肿瘤大小。无论造影时有无肿瘤血管染色 。

Objectives:The therapeutic effects of digital subtraction angiography (DSA) and transcatheter arterial chemotherapy (TAC) were observed in patients with colorectal cancer using histological comparative method. Materials and methods: DSA and TAC were performed in patients with colorectal cancer before operation. All tumors were resected within 2~4 weeks. The histological comparative study of the resected specimens were made between 96 patients receiving TAC and 40 patients receiving tumor resection only. Results: Among 96 cases of DSA , 55 cases showed tumor vessel stain(57.3%).They were directly proportional to the degrees of malignancy,depth of invasion and the size of the tumors. TAC can not only kill tumor cells, but also result in degenerative changes and necrosis of vascular endothelia and stimulate inflammatory cell infiltration and fibroplasia to the tumor mesenchyma. Conclusions:DSA and TAC are not only helpful to the estimation of operability and selection of therapeutic regimen,but also have satisfactory chemotherapeutic effect in colorectal cancer.