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目的研究术前化疗在治疗小儿成神经细胞瘤中的作用。方法对照研究应用术前化疗后切除的成神经细胞瘤２１例，观察尿香草扁桃酸（ＶＭＡ）、ＤＮＡ图象分析和ＭＹＣＮ基因变化。结果手术切除率为９５５％，平均生存时间为２８１±１０２ｍｏ，显著高于一期手术组的８８±６８ｍｏ（Ｐ＜００１）。化疗后尿ＶＭＡ较化疗前降低（Ｐ＜００１）。化疗后肿瘤细胞ＤＮＡ指数下降，Ｇ０＋Ｇ１时相比例升高，ＭＹＣＮ基因表达明显抑制。结论术前化疗具有诱导成神经细胞瘤细胞凋亡和促使肿瘤细胞增殖活性降低的作用。
Objective To study the role of preoperative chemotherapy in the treatment of pediatric neuroblastoma. Methods Control study 21 cases of neuroblastoma resected after preoperative chemotherapy were used to observe the change of VMA, DNA image analysis and MYCN gene. Results The surgical resection rate was 95.5%, and the average survival time was 281 ± 102 months, which was significantly higher than that of the first operation group (88 ± 68 months, P <001). Urinary VMA decreased after chemotherapy (P <001). After chemotherapy, DNA index of tumor cells decreased, the proportion of G0 + G1 phase increased, MYCN gene expression was significantly inhibited. Conclusion Preoperative chemotherapy induces apoptosis of neuroblastoma cells and decreases the proliferation activity of tumor cells.