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目的:比较结肠癌术中区域化疗(regional chemotherapy,RC)与肠腔化疗门静脉、周围静脉、腹腔液和癌旁组织5-Fu的浓度。方法:结肠癌术中,RC组经区域动脉灌注含5-Fu(15.0 mg/kg)的化疗液100.0 mL,肠腔化疗组经肠腔灌注含5-Fu(15.0 mg/kg)的化疗液100.0 mL,于注药后2、5、10、20、30、60 min分别采集门静脉血液、周围静脉血液、腹腔液和癌旁组织,高效液相色谱法测定样本5-Fu浓度。结果:RC组各样本注药后2 min即出现峰浓度,并逐渐降低,其中腹腔液血药浓度最高,周围静脉血血药浓度低于门静脉血。肠腔化疗组,门静脉血液、腹腔液和癌旁组织在注药后2 min即测得5-Fu,但浓度显著低于RC组(P<0.01),此后,门静脉血5-Fu浓度上升,并于60 min高于RC组(P<0.01);周围静脉血未测得5-Fu。结论:结肠癌术中RC可使门静脉血液和腹腔液维持比较高的血药浓度,对术中转移和术后复发具有治疗和预防作用。
OBJECTIVE: To compare the concentration of 5-Fu between portal vein, peripheral veins, peritoneal fluid, and paracancerous tissue treated with regional chemotherapy (RC) and enterointestinal chemotherapy for colon cancer. Methods: In the operation of colon cancer, RC group received intraperitoneal arterial infusion of 5-Fu (15.0 mg/kg) in 100.0 mL of chemotherapeutic solution, while the enterointestinal chemotherapy group received 5-Fu (15.0 mg/kg) in chemotherapeutic solution. 100.0 mL was collected at 2, 5, 10, 20, 30, and 60 min after drug injection. Portal vein blood, peripheral vein blood, peritoneal fluid, and paracancerous tissue were collected. The concentration of 5-Fu was determined by high performance liquid chromatography. RESULTS: The peak concentration appeared in 2 minutes after injection of each sample in the RC group, and gradually decreased. The plasma concentration of the abdominal fluid was highest, and the concentration of peripheral blood was lower than that of portal vein blood. In the intestine chemotherapy group, portal vein blood, peritoneal fluid, and paracancerous tissues were detected 5-Fu at 2 min after injection, but the concentration was significantly lower than that in the RC group (P<0.01). Thereafter, the concentration of 5-Fu in portal vein blood increased. It was higher than RC group at 60 min (P<0.01); 5-Fu was not detected in peripheral venous blood. Conclusion: Intraoperative RC of colon cancer can maintain high blood concentration in portal vein and peritoneal fluid, which has therapeutic and preventive effects on intraoperative metastasis and postoperative recurrence.