胃镜下瘤内注射重组人腺病毒p53联合食管支架植入治疗晚期食管癌的临床研究

Clinical study of endoscopic intratumor injection of recombinant human adenovirus p53 （rAd-p53） combined with esophageal stent implantation in the treatment of advanced esophageal cancer

目的 对比观察单纯支架植入与瘤内注射重组人腺病毒p53联合支架植入治疗晚期食管癌患者的疗效及并发症的发生率.方法 24例晚期食管癌,只能进食半流质、流质食物或不能进食,随机分为对照组（A组）及治疗组（B组）.A组12例采用单纯食管支架植入,B组12例胃镜下瘤内注射重组人腺病毒p53联合食管支架植入.结果 两组吞咽困难改善率差异无统计学意义;生存期：治疗组术后生存时间为3.2 ～38个月,平均（27.0±2.3）个月,而对照组术后生存时间为2.8 ～27个月,平均（14.7±8.0）个月,两组差异有统计学意义（t=3.521,P＜0.05）;再狭窄率发生率治疗组为8.3％,对照组为41.7％,两组差异有统计学意义（x2 =7.532,P＜0.05）.结论 胃镜下瘤内注射重组人腺病毒p53联合食管支架植入治疗晚期食管癌可以延长患者生存时间,并降低食管支架植入再狭窄的发生率.

Objective To compare the efficacy and incidence of complications of stenting alone and intratumoral injection of recombinant human adenovirus p53 combined with stent implantation in the treatment of advanced esophageal cancer patients.Methods 2 4 cases with advanced esophageal cancer,who could only eat semi liquid,liquid food or could not eat,were randomly divided into control group（A group） and treatment group （B group）.12 cases in A group were treated with esophageal stent implantation,12 cases in B group were given endoscopic intratumor injection of recombinant human adenovirus p53 combined with food tract stent implantation.Results The rate of improvement of dysphasia had no significant difference in survival period：the treatment group survival time of 3.2-38 months,mean （27.0 ± 2.3） months,while the control group survival time of 2.8-27months,an average of （14.7 ± 8.0） months,the difference between the two groups was significant （t =3.521,P 〈 0.05）.The incidence rate of restenosis in treatrnent group was 8.3%,that in control group was 41.7%.There was significant difference （x2 =7.532,P 〈0.05）.Conclusion Endoscopic intratumor injection of recombinant human adenovirus p53 combined with esophageal stent implantation in the treatment of advanced esophageal carcinoma can prolong the survival time of patients with esophageal stent implantation,and to reduce the incidence of restenosis.