术前介入动脉化疗对胰腺癌细胞凋亡和细胞增殖的影响

Effects of preoperative selective chemotherapy via arteries on apoptosis and proliferation of pancreatic adenocarcinoma cells

目的 检测术前选择性介入动脉化疗对胰腺癌细胞凋亡和细胞增殖的作用 ,探讨区域性化疗抑制胰腺癌生长的分子机制。方法 采用原位末端标记法 (ISEL)对 3 2例术前行介入化疗和未化疗的胰腺癌患者的病理切片进行细胞凋亡指数和增殖指数的检测 ,同时测定细胞凋亡调控基因bcl 2和bax的表达水平。结果 ( 1)术前介入化疗组胰腺癌细胞凋亡率比未介入化疗组明显增高 ,两组的细胞凋亡率分别为 ( 4 6 89± 2 6 46)和 ( 5 67± 2 43 ) (P <0 0 1) ;而细胞增殖指数 (PCNA)在术前介入化疗组与非化疗组之间无显著差异 (P >0 0 5 )。 ( 2 )肿瘤细胞凋亡率与组织类型有关 ,高分化腺癌中的细胞凋亡率比低分化腺癌高 (P <0 0 5 )。 ( 3 )术前介入化疗组bcl 2表达率低于未介入化疗组 ,bax表达率高于未介入化疗组 (P <0 0 5 )。结论 术前选择性的动脉介入化疗能够诱导胰腺细胞凋亡 ,诱导细胞凋亡是抑制胰腺癌细胞的生长重要途径。

Objective To investigate the effects of preoperative selective chemotherapy via arteries on apoptosis and proliferation of pancreatic adenocarcinoma cells. Methods Apoptotic index (AI) in 32 cases of pancreatic adenocarcinoma with or without preoperative selective chemotherapy via arteries was detected with in situ end labeling (ISEL) and expression of PCNA, Bcl-2 and Bax in them determined with immunohistochemistry. Results (1) AI was significantly higher in cases with preoperative selective chemotherapy via arteries than in those without (P<0.01). No correlation in expression of PCNA was found between the two groups of patients (P>0.05). (2) AI was related to differentiation of pancreatic adenocarcinoma. AI was significantly higher in patients with highly differentiated pancreatic adenocarcinoma than in those with poorly differentiated one (P<0.05). (3) Expression of bcl-2 was significantly lower but that of bax markedly higher in patients with preoperative selective chemotherapy via arteries than in those without (P<0.05). Conclusions Preoperative selective chemotherapy via arteries can effectively inhibit pancreatic adenocarcinoma through inducing the apoptosis of tumor cells.