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目的探讨术前区域动脉灌注化疗联合放疗对低位直肠癌术后p53表达及细胞凋亡的影响。方法对45例低位直肠癌病例随机分为3组,每组各15例,A组进行术前化、放疗,B组术前单纯放疗,C组术前未行任何化、放疗。采用免疫组化S-P法检测每例治疗前及手术后的p53表达,采用原位末端标记技术检测细胞凋亡。结果全部施行根治性切除术。A组治疗前后p53阳性表达分别为53.33%和20.00%,B组分别为60.00%和33.33%,差异有统计学意义(P<0.01);C组分别为53.33%和40.00%,差异无统计学意义(P>0.05)。3组治疗前p53阳性表达之间无明显差异,3组术后p53阳性表达之间差异有统计学意义(P<0.01)。A组治疗前后凋亡指数(apoptosis indexes,AI)分别为(8.98±1.07)‰和(53.96±1.21)‰,B组分别为(8.80±1.00)‰和(27.64±0.58)‰,差异有统计学意义(P<0.01);C组分别为(9.32±1.41)‰和(8.68±1.42)‰,差异无统计学意义(P>0.05)。3组治疗前AI之间差异无统计学意义,3组术后AI之间差异有统计学意义(P<0.01)。结论低位直肠癌采用PRAC联合放疗可以降低p53表达和促进癌细胞凋亡、提高疗效,它是对低位直肠癌治疗的有效和合理的措施。
Objective To investigate the effect of preoperative regional arterial infusion chemotherapy combined with radiotherapy on p53 expression and apoptosis in postoperative low rectal cancer. Methods Forty-five cases of low rectal cancer were randomly divided into three groups, 15 cases in each group. Group A received preoperative radiotherapy and radiotherapy. Group B received preoperative radiotherapy alone without any chemotherapy or radiotherapy. The expression of p53 in each group before and after the operation was detected by immunohistochemical S-P method. Apoptosis was detected by in situ terminal labeling. The results of the implementation of radical resection. The positive expression of p53 in group A before and after treatment was 53.33% and 20.00%, respectively, while in group B 60.00% and 33.33%, the difference was statistically significant (P <0.01); the C group was 53.33% and 40.00% respectively, with no statistical difference Significance (P> 0.05). There was no significant difference between the three groups in the expression of p53 before treatment. The difference between the three groups in the expression of p53 was statistically significant (P <0.01). The apoptotic index (AI) of group A before and after treatment were (8.98 ± 1.07) ‰ and (53.96 ± 1.21) ‰, respectively, while those in group B were (8.80 ± 1.00) ‰ and (27.64 ± 0.58) ‰, respectively (9.32 ± 1.41) ‰ and (8.68 ± 1.42) ‰, respectively. The difference was not statistically significant (P> 0.05). There was no significant difference in the AI between the three groups before treatment, and there was significant difference between the three groups in postoperative AI (P <0.01). Conclusion PRAC combined with radiotherapy can reduce the expression of p53 and promote the apoptosis of cancer cells in low rectal cancer and improve the curative effect. It is an effective and reasonable measure for the treatment of low rectal cancer.