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目的：研究和评估胃癌患者术前介入治疗的疗效。方法：对２５０例胃癌患者术前进行介入治疗，采用Ｓｅｌｄｉｎｇｅｒ法经一侧股动脉置管达癌肿部位主要动脉，一次性注入化疗药物，５－Ｆｕ５００ｍｇ／ｍ２，Ｅｐｉａｄｒａｍｙｃｉｎ４００ｍｇ／ｍ２，ＭＭＣ１５ｍｇ／ｍ２。在化疗后７～１０天后行根治性切除术，介入组中随机选择８２例并观察大体标本和癌肿组织病理学改变，对照组４０例术前未进行化疗，直接手术切除，进行病理学对比研究，观察大体标本和取癌肿中心部位组织进行病理学观察，详细记录介入化疗的不良反应。结果：①介入组总有效率为７３．２％，癌组织细胞呈典型凋亡特点，间质的炎性反应和纤维组织增生比对照组明显；②介入组６３％出现中～重度坏死，且５６．７％发生在血管周围，对照组只有３０％存在坏死，且与血管无关；③介入组血管内膜增厚和血管内血栓发生率为９５％和７５％，对照组仅为３５％和５％；④随访１、３、５年存活率为９２．９％、５７．１％和４２．８％。单纯行剖腹探查术者半年存活率为７８．２％，１年存活率３４．８％。结论：术前介入治疗能够提高３年和５年存活率，也能作为姑息治疗的一种手段，并能延长存活时间。
Objective: To study and evaluate the efficacy of preoperative interventional therapy for gastric cancer patients. Methods: Two hundred and fifty patients with gastric cancer were treated with interventional therapy before operation. Seldinger method was used to place the femoral arteries in one side of the main artery of the cancer site. One-time injection of chemotherapy drugs, 5-Fu 500mg/m2, Epiadramycin 400mg/m2, MMC15mg/m2. Radical resection was performed 7 to 10 days after chemotherapy. 82 patients were randomly selected in the intervention group and gross and histopathologic changes were observed. In the control group, 40 patients were not treated with chemotherapy before surgery and were directly resected for pathological comparison. Research, observation of gross specimens and the central part of the cancerous tissue for pathological observation, detailed records of the adverse reactions of interventional chemotherapy. RESULTS: 1 The total effective rate was 73.2% in the intervention group. The cancer cells showed typical apoptotic characteristics. The interstitial inflammatory reaction and fibrous tissue hyperplasia were more obvious than the control group; 2 moderate to severe necrosis occurred in 63% of the intervention group. 56.7% occurred around the blood vessels. Only 30% of the control group had necrosis and had nothing to do with the blood vessels. 3Intimal thickening and intravascular thrombosis occurred in 95% and 75% of the intervention group, and only 35% in the control group. The survival rates of 5%; 4 follow-up 1, 3, and 5 years were 92.9%, 57.1%, and 42.8%. The six-year survival rate for a simple laparotomy was 78.2%, and the one-year survival rate was 34.8%. CONCLUSIONS: Preoperative interventional therapy can improve 3-year and 5-year survival rates. It can also be used as a palliative treatment and can prolong survival.