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目的 了解术前化疗对胃腺癌细胞凋亡的影响。方法 采用抽签法术前随机分为口服脱氧氟尿苷(5′- DFUR)组(18例)、静脉输注5- FU +CF组(16例)及对照组(2 0例)。化疗结束后第1～2天手术。采用免疫组织化学及TUNEL法检测癌细胞增殖指数(PI)及凋亡细胞指数(AI)。结果 PI在5′-DFUR组(40±13)、5 - FU +CF组(41±15 )明显低于对照组(5 8±16 ) ,差异有统计学意义(P =0 . 0 0 0 ) ;AI在5′- DFUR组(14±9)、5 - FU +CF组(14±10 )明显高于对照组(7±7) ,差异有统计学意义(P =0 . 0 17)。4 4例获得随访。总的0 . 5、1、2年生存率分别为93%、86 %、70 % ,0. 5、1、2年无瘤生存率分别为89%、77%、6 7%。3组术后生存时间差异无统计学意义。结论 术前3～5d短程口服5′- DFUR化疗可诱导胃腺癌细胞凋亡,降低癌细胞增殖指数,但不能改善术后生存情况。
Objective To investigate the effect of preoperative chemotherapy on gastric adenocarcinoma cell apoptosis. Methods The patients were randomly divided into 5 groups (18 cases), 5-DFUR group (16 cases) and control group (20 cases). 1 to 2 days after the end of chemotherapy surgery. Immunohistochemistry and TUNEL were used to detect the proliferation index (PI) and apoptotic index (AI) of cancer cells. Results The PI was significantly lower than that of the control group (40 ± 13), 5 - FU + CF group (41 ± 15), and the difference was statistically significant (P = 0. 0 0 0 ) In AI group (14 ± 9), 5 - FU + CF group (14 ± 10) was significantly higher than that in control group (7 ± 7), the difference was statistically significant (P = 0.017) . 4 4 cases were followed up. The overall 0.5, 1, 2-year survival rates were 93%, 86%, 70%, 0.5, 1, 2 year disease-free survival rates were 89%, 77%, 67%. There was no significant difference in survival time between the three groups after operation. Conclusion Short-range oral 5’- DFUR chemotherapy 3 ~ 5 days before induction can induce gastric adenocarcinoma cell apoptosis and reduce the proliferation index of cancer cells, but can not improve the postoperative survival.