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目的探讨临床行卡铂腹腔内化疗前加用奥曲肽对胃癌淋巴结转移灶癌细胞凋亡的影响。方法 40例胃癌伴淋巴结转移患者行胃癌根治性切除术。20例腹腔化疗前加用奥曲肽(0.1 gq8h.×3)为治疗组,另外20例未用奥曲肽作为对照组。用免疫组化ABC法检测淋巴转移灶p53蛋白(p53)、B细胞淋巴瘤-白血病2(Bcl-2)及Bcl相关X蛋白(Bax)基因表达,TUNEL法检测细胞凋亡。结果治疗组淋巴转移灶p53和Bax表达较对照组明显增强(P<0.05),并与细胞凋亡呈正相关;Bcl-2表达降低,并与细胞凋亡呈负相关。结论胃癌术前腹腔化疗前加用奥曲肽可能通过p53、Bcl-2及Bax介导使转移淋巴结癌细胞凋亡增加,有助于提高根治性手术的治疗效果。
Objective To investigate the clinical effect of adding octreotide before carboplatin intraperitoneal chemotherapy on apoptosis of gastric cancer with lymph node metastasis. Methods Forty patients with gastric cancer with lymph node metastasis underwent radical resection of gastric cancer. 20 cases of intraperitoneal chemotherapy with octreotide (0.1 gq8h. × 3) for the treatment group, the other 20 cases did not use octreotide as a control group. The expression of p53 protein, Bcl-2 and Bcl-2 in lymph node metastasis were detected by immunohistochemical ABC method. Apoptosis was detected by TUNEL method. Results The expression of p53 and Bax in lymphatic metastasis group was significantly higher than that in control group (P <0.05), and was positively correlated with apoptosis. The expression of Bcl-2 was decreased and negatively correlated with apoptosis. Conclusion The addition of octreotide before gastric cancer preoperative intraperitoneal chemotherapy may increase the apoptosis of metastatic lymph node cancer cells through p53, Bcl-2 and Bax, which may help to improve the curative effect of radical surgery.