术前化疗诱导食管癌细胞凋亡的研究

Apoptosis induction of preoperative chemotherapy for esophageal cancer

目的 观察术前化疗对食管癌细胞凋亡的诱导作用。方法 术前化疗方案采用BPF方案 ,采用DNA末端标记法染色观察食管癌术前化疗组 (62例 )化疗前胃镜标本和手术标本石蜡切片及 3 5例单纯手术组的手术标本石蜡切片肿瘤细胞凋亡情况。结果 术前化疗组患者中 5 4例自觉吞咽困难、上腹部不适等症状明显改善 ,8例无变化 ,无症状加重者。消化道钡餐检查示CR 9例 ,PR 3 7例 ,NC 1 2例 ,PD 4例。术后常规病理检查发现除病变进展的 4例外 ,其余 5 8例均可见化疗后改变。术前化疗组的胃镜标本肿瘤细胞凋亡指数平均为 (5 .2± 1 .3 ) % ,术后标本为 (2 7.6± 3 .8) %。单纯手术组术后标本肿瘤细胞凋亡指数为 (4 .9± 1 .6) %。结论 术前使用顺铂、5 Fu、平阳霉素联合化疗可以诱导食管癌细胞发生凋亡。

Objective To investigate the apoptosis of esophageal cancer induced by preoperative chemotherapy. Methods By using the method of TUNEL, we determined the apoptosis of cancer cells in specimens of endoscopy and postoperation in 62 patients who were treated with preoperative chemotherapy, only postoperation in 35 patients without preoperative chemotherapy. The chemotherapy regimen was DDP, 5Fu and Beolymecine.Results The symptoms improved in thiryt eight patients after the preoperative chemotherapy, and none progressed. In chemotherapy group, 9 patients had CR, 35 had PR, 12 had NC and 4 had PD. The apoptosis index of the preoperative group was 5.2±1.3% in endoscopic specimen and 27.6±3.8% in postoperative specimen. The apoptosis index of surgery group was 4.9±1.6%.Conclusion The preoperative chemotherapy could induce the apoptosis of esophageal cancer.