脱氧氟尿苷术前口服化疗对胃癌组织PD-ECGF表达影响及意义.docVIP

脱氧氟尿苷术前口服化疗对胃癌组织PD-ECGF表达影响及意义 　 作者：王世夫，赵文和，丁伟，盛建明，马志敏，滕理送，王敏 罗斌，吴福生 【摘要】 ［目的］ 了解术前脱氧氟尿苷口服化疗对胃癌组织血小板衍化内皮细胞生长因子（PD-ECGF）表达的影响及意义。［方法］ 胃癌患者术前随机分为三组：组1：氟铁龙800mg/d~1200mg/d, 3~5天；组2：5-Fu 0.5+CF 200mg/d 静脉滴注，3~5天；组3：对照组。化疗结束后第1~2天行手术。切除标本采用免疫组化法及TUNEL法检测胃癌组织中PD-ECGF表达率及细胞凋亡指数（AI）。［结果］ 全组PD-ECGF阳性率为51.9%。PD-ECGF表达率与根治切除、肿瘤侵犯深度、淋巴结转移、有无远处转移及UICC分期无关（P＞0.05）。组1中PD-ECGF表达率（28.6%，4/18）明显低于组2（56.3%，9/16）及对照组（65.0%，13/20）（P=0.023）。AI在组1为14.39±9.49，组2为14.11±9.68，明显高于对照组(6.88±7.37)。在PD-ECGF阳性组中肿瘤细胞凋亡指数（8.12±5.19）明显低于阴性组（14.69±11.23），差异有显著性（F=7.409，P=0.009）。随访截止至2006年12月31日，50例获得随访，总的1、2、3、5年生存率分别为78.0%、58.8%、48.7%、48.7％。PD-ECGF阳性患者1、2、3、5年生存率分别为76.0%、56.0%、47.7%、47.7%；低于阴性组的80.0%、60.0%、52.0%、52.0%，但差异无显著性（χ2＝0.177，P=0.674）。［结论］ 术前脱氧氟尿苷口服化疗可降低胃癌组织中PD-ECGF表达率。PD-ECGF阳性表达患者的肿瘤细胞凋亡指数低于阴性组，倾向预后不良。 【关键词】 胃肿瘤 The Influences of Preoperative Oral 5′-DFUR Administration on PD-ECGF in Gastric Carcinoma Abstract： ［Purpose］ To investigate the influences and significance of preoperative oral 5′-deoxy-5-fluorouridine(5′-DFUR) administration on expression of platelet-derived endothelial cell growth factor (PD-ECGF) in gastric carcinoma. ［Methods］ The patients with gastric cancer were divided randomly into three groups, group 1, 5′-DFUR 800mg~1200mg per day for 3 to 5 days; group 2, 5-Fu 500mg + CF 200mg per day for 3 to 5 days; and group 3, the controls. Surgery was performed 1 or 2 days after chemotherapy. The expression of PD-ECGF and apoptosis index (AI) of gastric carcinoma cell were detected by immunohistochemical staining and in-situ TUNEL respectively. ［Results］ The positive expression rate of PD-ECGF was 51.9% in all patients with gastric cancers. PD-ECGF expression did not significantly correlate to radical resection, depth of invasion, lymphatic metastasis and UICC staging(Pgt;0.05). The rate of PD-ECGF expression in group 1 was 28.6% (4/18), it was significantly lower than that in group 2（56.3%, 9/16）and control group (65.0%, 13/20) （P=0.023）. The AI was 14.39±9.49 in group 1 and