术前介入治疗对肾母细胞瘤细胞增殖和凋亡的影响

The effects of preoperative interventional therapy on cell proliferation and apoptosis of nephroblastoma

目的 探讨介入治疗 (动脉化疗栓塞 )对肾母细胞瘤细胞增殖与凋亡的影响。方法 观察术前介入组 17例和单纯手术组 2 2例肾母细胞瘤标本的分裂指数和凋亡指数的差异 ,细胞凋亡的检测采用DNA转移酶dUTP缺口末端标记法 (TUNEL)。结果 术前介入组肿瘤细胞平均分裂指数为 0 .4 2± 0 .2 1,明显低于单纯手术组 2 .4 0± 1.0 1(P <0 .0 1) ;术前介入组肿瘤细胞平均凋亡指数为5 0 .6± 4 8.1,明显高于单纯手术组 19.7± 2 .82 (P <0 .0 1)。结论 抑制肿瘤细胞增殖、诱导肿瘤细胞凋亡是肾母细胞瘤术前介入治疗产生疗效的重要机制。

Objective To evaluate the influence of preoperative interventional therapy on cell proliferation and apoptosis of nephroblastoma.Methods A randomized, controlled trial was conducted, 17 of 39 received chemotherapy before surgical excision ( interventional therapy group, ITG ) and studied as test group. The other 22 patients only had surgical excision ( surgical excision group,SEG), and studied as control group. The mitotic index and apoptotic index of interventional group was compared to that of simple resection group. Apoptosis cells were stained using terminal deoxynucleotigyl transferase medical dUTP X nick end labeling (TUNEL). Neoplastic cell mitosis was counted in 10 high power fields(10×40),the mean number of mitosis in per field was calculated as the neoplastic cell mitotic index. Apoptotic index (AI) was counting the number of positive signal of cell apoptosis in 10 high power fields(10×40), the mean number of apoptosis in per field was evaluated as the neoplastic cell apoptotic index.Results The average mitotic index in tumor cells was 0.42 ± 0.21 in interventional group, and 2.41 ± 1.01 in simple resection group ( P < 0.01 ). The average apoptotic index (AI) of the tumor cells was 50.6 ± 48.1 in study group and 19.7 ± 2.82 in control group ( P < 0.01 ). There was no statistical difference in MI and AI between different pathological subtypes.Conclusion The preoperative interventional treatment inhibits tumor cell growth and induces apoptosis in tumor cells.