术前新辅助化疗结合肠内营养对胃癌患者肿瘤细胞增殖活性的影响

Effect of neoadjuvant chemotherapy combined with enteral nutrition on proliferative activity of tumor cells in patients with gastric cancer

目的探讨胃癌患者术前新辅助化疗(NAD)结合肠内营养(EA)对肿瘤细胞增殖活性的影响。方法2011年10月-2012年10月,郑州大学附属肿瘤医院普外科收治的胃癌患者66例,采用随机数字表法分为对照组22例,NAD组20例,NAD+EA组24例,分别检测干预治疗前后肿瘤细胞DNA非整倍体肿瘤DNA指数(DI),S期分数(SPF值),S+G2+M期PI值。结果治疗前后组内比较:NAD组治疗后SPF值及PI值较治疗前均显著降低,差异有统计学意义(P<0.05),DI指数治疗前后无明显差异(P>0.05);EA+NAD组治疗后SPF,PI,DI值均较治疗前下降,差异有统计学意义(P<0.05)。治疗后组间比较:EA+NAD组治疗后SPF,DI值与NAD组和对照组比较显著降低,差异有统计学意义(P<0.05),PI值NAD组和对照组比较无明显差别(P>0.05)。结论胃癌患者术前NAD结合EA能使肿瘤的增殖活性下降,从而使更多的肿瘤细胞被化疗药物杀死,提高了化疗有效率。

【Objective】To evaluate the effect of neoadjuvant chemotherapy combined with enteral nutrition on the proliferative activity of tumor cells in patients with gastric cancer.【Methods】 A total of 66 patients with gastric cancer administrated to our hospital from Oct., 2011 to Oct., 2012 were randomly divided into the control group（n =22）, simple neoadjuvant chemotherapy group（group NAD, n =20） and neoadjuvant chemotherapy plus enteral nutrition group（group NAD ＋EA,n =24）. The tumor cell aneuploid DNA index（DI）, the S-phase fraction value（SPF）, PI value of S＋G2＋M phase were measured before and after the intervention. 【Results】The SPF and PI were decreased after treatment in the group NAD with statistically difference（P〈0.05）. But the DNA aneuploidy rate（DI）did not change significantly before and after treatment（P〉0.05）. The SPF, PI and DI were significantly decreased in the group NAD＋EA after treatment（P〈0.05）. After treatment, the group NAD＋EA had significantly lower SPF and DI compared with other two groups（P〈0.05）.【Conclusions】Preoperative neoadjuvant chemotherapy combined with enteral nutrition in gastric cancer patients can decrease tumor proliferation activity, so that more tumor cells could be killed by chemotherapy.