奥沙利铂联合5-Fu术前短程冲击化疗对诱导结直肠癌细胞凋亡的影响

目的：探讨奥沙利铂（L-OHP）联合五氟尿嘧啶（5-Fu）术前短程冲击化疗对结直肠癌细胞凋亡的影响，为结直肠癌新辅助化疗方法提供理论依据。方法对60例结直肠癌患者均分为两组，一组术前采用L-OHP联合5-Fu短程冲击化疗，另一组术前不作化疗。采用RT-PCR法检测凋亡抑制基因Survivin mRNA的表达，用免疫组化检测bcl-2、p53及ki-67的表达，用流式细胞术检测细胞凋亡情况。结果相较于对照组，新辅助化疗组Survivin mRNA表达水平明显降低，bcl-2、ki-67阳性面积率及p53阳性面积率也明显降低，差异均有统计学意义（P〈0.05），细胞凋亡率高于对照组（P〈0.05）。结论术前L-OHP短程冲击化疗能够诱导癌细胞凋亡，可能是通过下调survivin mRNA的表达来调控或协同其他凋亡因子，从而达到新辅助化疗治疗的效果。

ObjectiveTo investigate the impact of preoperative short range chemotherapy by oxaliplatin combined with 5-Fu on the cell apoptosis of colorectal cancer,and provide reference and theoretical basis for the effective and safe method of neoadjuvant chemotherapy on colorectal cancer.Method After the short rangechemotherapy by oxaliplatin combined with 5-fu before preoperative to the patients,to detect apoptosis gene Survivin mRNA by RT-PCR,to detect bcl-2、p53、ki-67 by immunohistochemical staining and to detect the apoptosis by flow cytometry. Experimental groups： Neoadjuvant therapy group（40-80 years old,diagnosed with colorectal cancer,with no acute intestinal obstruction,bleeding and other complications etc.,Cardiopulmonary function were tolerated surgery and preoperative shock short-range chemotherapy）; Control group（40-80 years old,diagnosed with colorectal cancer before or after Surgery,with no acute intestinal obstruction,bleeding and other complications etc.,Cardiopulmonary function were tolerated surgery and preoperative shock short-range chemotherapy）.ResultsIt showed that expression of Survivin mRNA detected by RT-PCR in Neoadjuvant chemotherapy group was lower than that in the control group（P〈0.05）; and positive expression rate of bcl-2、ki-67 detected by immunohistochemical staining showed a significant decrease in neoadjuvant chemotherapy contrast with control group（P〈0.05）; positive expression rate of p53 also showed a significant change between Neoadjuvant chemotherapy group and control group.（P〈0.05）; Flow cytometry showed that apoptosis rate in Neoadjuvant chemotherapy group was higher than the control group（P〈0.05）.Conclusion Preoperative shock short-range chemotherapy can induce cell apoptosis of colorectal cancer and inhibit their proliferation significantly; and it is speculated that neoadjuvant chemotherapy might regulate or cooperate with the expression of other apoptotic factors through down-regulated survivin expression so as to achieve the treatment effect of neoadjuvant chemotherapy.