术前静脉滴注鸦胆子乳剂治疗肺癌的临床病理研究

PREOPERATIVE INTRAVENOUS DRIP OF AN ANTI-TUMOR CHINESE HERB PREPARATION,BRUCEA JAVANICA OIL EMULSION (YA DAN ZI EMULSION) FOR LUNG CANCER

作者对81例肺癌患者术前静滴鸦胆子乳剂(2周以上),其中鳞癌37例,腺癌35例,腺鳞癌4例,小细胞未分化癌5例。手术方式包括全肺切除16例,肺叶(双叶在内)57例,楔形切除2例,剖胸探查1例,(5例未手术)。术中未发现易于渗血,严重纤维化或特殊病理组织上改变而影响切除操作。切除病肺病理学检查示大部分肿瘤及淋巴结有坏死,部分呈轻度增生,纤维化不明显:电镜下示恶性细胞出现核周间隙增宽,线粒体膨化,内质网扩张,质膜系统出现局限性中断至细胞完全崩解。提示该制剂具有一定抗癌作用。以鳞癌较为突出,腺癌次之,而小细胞未分化癌不明显。3/4病例有较明显或明显的癌周淋巴细胞,提示对机体的细胞免疫无抑制现象。

Eighty-one cases of primary lung cancer were treated with intravenous 10% Bruceajavanica oil emulsion(Ya Dan Zi emulsion)for 14 days before operation.The liver andkidney functions of the patients were not effected but 2 had fever which subsided afterstoppage of infusion.Seventy-six patients underwent thoracotomy,including pneumnectomy16,lobectomy 57,wedge excision 2 and 1 exploration.There were no signs of oozing,serious fibrosis or increased difficulties during surgical dissection or resection.Light andelectron microscopic examination of surgical specimens revealed that the anti-tumor effectof Ya Dan Zi emulsion was on the plasmalemma system and mitochondria.The drug wasmost effective in squamous carcinoma and adenocarcinoma but not in small cell lung can-cer.It did not inhibit immune function and there was no gartrointestinal upset or bonemarrow suppression.Therefore,preoperative intravenous Ya Dan Zi emulsion may improvesurgical treatment of non-small cell lung cancer.