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目的检测大肠癌患者根治术中植入氟尿嘧啶植入剂后外周血survivin、caspase-3、CD44V6的变化,探讨其对肿瘤微转移及预后的影响。方法 64例大肠癌患者(Dukes B期、C期)随机分为治疗组和对照组,每组32例。2组均行标准根治术,治疗组术中植入氟尿嘧啶植入剂;对照组术中未应用此药。采用RT-PCR方法测定手术前后外周血中survivin、caspase-3表达水平,流式细胞术检测CD44V6含量。结果术前2组survivin、caspase-3、CD44V6的水平差异无统计学意义(P>0.05);术后14 d,治疗组survivin水平(0.362±0.183)低于对照组(0.585±0.207),caspase-3水平(2.001±0.146)高于对照组(1.654±0.111);术后CD44V6水平治疗组(1.857±0.535)和对照组(3.471±0.496)明显低于术前的(9.557±1.170)和(9.729±0.943),且治疗组CD44V6水平低于对照组(均P<0.05)。结论术中植入氟尿嘧啶植入剂,对大肠癌的微转移及预后有重要意义,有望提高大肠癌术后的远期疗效。
Objective To detect the changes of survivin, caspase-3 and CD44V6 in peripheral blood of patients with colorectal cancer after radical implantation of fluorouracil and investigate their effects on the tumor micrometastasis and prognosis. Methods Sixty-four patients with colorectal cancer (Dukes B, C) were randomly divided into treatment group and control group, 32 cases in each group. Both groups underwent standard radical mastectomy. The patients in the treatment group received intraoperative fluorouracil implants; in the control group, they did not receive this drug. The expression of survivin and caspase-3 in peripheral blood before and after operation was measured by RT-PCR and the level of CD44V6 was detected by flow cytometry. Results There was no significant difference in the levels of survivin, caspase-3 and CD44V6 between the two groups before operation (P> 0.05). On the 14th day after operation, the level of survivin in treatment group (0.362 ± 0.183) was lower than that in control group (0.585 ± 0.207) (1.857 ± 0.535) and control group (3.471 ± 0.496) were significantly lower than those of preoperative (9.557 ± 1.170) and (9.557 ± 1.170) 9.729 ± 0.943), and the level of CD44V6 in the treatment group was lower than that in the control group (all P <0.05). Conclusion Intraoperative implantation of fluorouracil implants is of great importance to the micrometastasis and prognosis of colorectal cancer, and it is expected to improve the long-term efficacy of colorectal cancer after operation.