FPLC直肠黏膜下多点注射治疗直肠癌淋巴结转移的临床研究

Clinical study on FPLC rectal submucosal multi-point injection in treating rectal cancer lymph node metastasis

目的探讨复方氟尿嘧啶多相脂质体（FPLC）直肠黏膜下多点注射对直肠癌淋巴结转移的影响。方法将符合纳入标准的100例直肠癌患者随机分为观察组与对照组,各50例,观察组术前60 h、36 h分别于直肠黏膜下多点注射FPLC,80 mg/次,对照组不予以干预,两组均行直肠癌根治术,比较两组术后淋巴结转移、癌细胞凋亡指数（AI）、增殖指数（PI）及并发症情况。此外术后随访6~24个月,比较两组局部复发率。结果观察组MM率、淋巴结MM度分别为10.00%、1.57%,较对照组的30.00%、11.11%差异有统计学意义（P〈0.05）。观察组AI、PI分别为（2.087±0.076）、（37.167±18.254）,较对照组的（1.035±0.083）、（44.869±20.125）差异有统计学意义（P〈0.05）。观察组随访12个月、24个月局部复发率分别为4.00%、10.00%,较对照组的16.00%、26.00%差异有统计学意义（P〈0.05）。结论 FPLC直肠黏膜下多点注射能有效抑制直肠癌患者术后淋巴结转移及微转移灶,特别是微转移灶,同时能明显促直肠癌细胞凋亡,抑制其增殖,最终降低其局部复发率。

Objective To study effects of fluorouracil polyphase liposome compound（FPLC） rectal submucosal multi-point injection on rectal cancer lymph node metastasis. Methods 100 cases of rectal cancer patients who were in accordance with the inclusion criteria were divided into the observation group and the control group randomly（each 50 cases）, in the observation group, patients were injected with FPLC rectal submucosal multi-point injection with each dose of 80 mg at 60 h, 36 h before the operation, the control group was not carricd out intervention, all patients underwent radical resection of rectal carcinoma, postoperative lymph node metastasis, cancer cell apoptosis index（AI）, proliferation index（PI） and complications were compared between the two groups.During a follow-up period of 6 to 24 months, local recurrence rates in the two groups were compared. Results MM rate, lymph node MM degree of the observation group were 10.00% and 1.57% respectively, there was a statistical significance compared with the control group（30%, 11.11%）（P〈0.05）. AI and PI of the observation group were（2.087±0.076）,（37.167±18.254） respectively, there was a statistical significance compared with the control group（1.035±0.083）,（44.869±20.125）（P〈0.05）. Local recurrence rate of the observation group at 12 followed up months and 24 followed up months were 4.00% and 10.00%, there was a statistical significance compared with the control group（16.00%, 26.00%）（P〈0.05）. Conclusion FPLC rectal submucosal multi-point injection can inhibit postoperative lymph node metastasis and micrometastasis lesion of rectal cancer patients effectively, especially micrometastasis lesion, meanwhile it can obviously promote the apoptosis of rectal cancer cells,inhibit their proliferation, and reduce the local recurrence rate ultimately.