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目的:探讨胰腺癌术前24 h应用吉西他滨化疗的临床意义,观察胰腺癌组织Syk的表达及其组织病理学变化。方法:应用HE染色和免疫组化法,观察实验组(术前24 h应用吉西他滨化疗)及对照组(未行化疗)正常胰腺组织及其癌组织细胞形态学改变、Syk的表达,探讨Syk与p53关系。结果:HE染色,实验组可见胰腺肿瘤细胞坏死明显,细胞空泡变性增多,核固缩、凝固性坏死显著,肿瘤组织及其周围组织中可见大量淋巴细胞和嗜酸性细胞浸润。免疫组化法,对照组胰腺癌组织中Syk表达较低,染色浅,颗粒不明显,正常胰腺组织中Syk呈强阳性表达,颗粒明显;实验组胰腺癌细胞Syk的表达明显增强,染色深,颗粒粗,Syk染色接近正常胰腺组织表达。实验组正常胰腺组织、癌组织中Syk表达的阳性率分别为92．3%、69．2%。对照组正常胰腺组织、癌组织中Syk表达的阳性率分别为86．2%、54．5%;两组胰腺癌组织之间的Syk阳性表达率差异有显著统计学意义(P＜0．01)。实验组、对照组p53蛋白阳性表达率分别为79．3%、59．9%,与Syk阳性表达一致率分别为89%、84%,Syk的表达与p53表达呈正相关。实验组患者生存时间明显延长,与对照组相比有显著意义(P＜0．01)。结论:胰腺癌术前24 h应用吉西他滨化疗患者中位生存期延长,免疫组化可见Syk的阳性表达率上升。
Objective: To investigate the clinical significance of gemcitabine chemotherapy in patients with pancreatic cancer at 24 hours before operation, and to observe the expression of Syk and histopathological changes in pancreatic cancer. Methods: HE staining and immunohistochemistry were used to observe the morphological changes and Syk expression in normal pancreatic tissues and their cancerous tissues in experimental group (preoperative 24 hours gemcitabine chemotherapy) and in control group p53 relationship. Results: In HE staining, the necrosis of pancreatic tumor cells was observed in experimental group, the degeneration of cellular vacuoles was increased, nuclear pyknosis and coagulation necrosis were obvious, and a large number of lymphocytes and eosinophilic infiltration were observed in tumor tissues and surrounding tissues. The expression of Syk in pancreatic cancer tissues of the control group was lower, the staining was lighter, the particles were not obvious, the expression of Syk in pancreatic cancer cells was stronger than that in normal pancreatic tissues, Crude particles, Syk staining near normal pancreatic tissue expression. The positive rates of Syk in the normal pancreatic tissue and the cancerous tissue in the experimental group were 92.3% and 69.2% respectively. The positive rates of Syk in normal pancreatic tissues and cancerous tissues of control group were 86.2% and 54.5%, respectively. There was significant difference in the expression of Syk between the two groups (P <0.01) ). The positive rates of p53 protein in experimental group and control group were 79.3% and 59.9%, respectively. The positive rates of Syk and Syk were 89% and 84%, respectively. Syk expression was positively correlated with p53 expression. The survival time of the experimental group was significantly longer than that of the control group (P <0.01). CONCLUSIONS: The median survival of patients with pancreatic cancer treated with gemcitabine 24 h before surgery was prolonged, and the positive expression rate of Syk was increased by immunohistochemistry.