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目的探讨术前腹腔动脉灌注化疗对中晚期胃癌细胞凋亡和增殖的影响。方法采用原位末端标记法(TUNEL)、增殖细胞核抗原(PCNA)和凋亡抑制蛋白(Bc l-2)免疫组化检测技术,观察比较术前腹腔动脉灌注化疗组(31例)和未化疗手术组(32例)中晚期胃癌标本的凋亡指数、增殖指数和Bc l-2蛋白表达强度的差异。结果术前化疗组凋亡指数明显高于对照组(P<0.01),增殖指数明显降低(P<0.01),Bc l-2蛋白表达强度明显低于对照组(P<0.01)。凋亡指数与Bc l-2分值呈负相关(P<0.01),凋亡指数与增殖指数呈正相关(P<0.05)。治疗组治愈性切除率明显高于对照组(P<0.01),3年生存率高于对照组(P<0.05)。结论术前腹腔动脉插管化疗可诱导中晚期胃癌细胞凋亡,降低肿瘤细胞的增殖活力,提高治愈性切除率,改善患者生存率。诱导胃癌细胞凋亡可能与化疗药物降低Bc l-2基因蛋白的表达有关。
Objective To investigate the effect of preoperative intraperitoneal chemotherapy on apoptosis and proliferation of gastric cancer cells. Methods The immunohistochemical technique of TUNEL, PCNA and Bcl-2 was used in the study. The changes of tumor necrosis factor-α in preoperative celiac artery infusion chemotherapy group (31 cases) and non-chemotherapy group The difference of apoptosis index, proliferation index and Bcl-2 protein expression in the operation group (32 cases) with advanced gastric cancer specimens. Results The apoptosis index of preoperative chemotherapy group was significantly higher than that of control group (P <0.01), and the proliferation index was significantly decreased (P <0.01). The expression of Bcl-2 protein was significantly lower than that of control group (P <0.01). Apoptosis index was negatively correlated with Bcl-2 (P <0.01), and apoptosis index was positively correlated with proliferation index (P <0.05). The curative resection rate of the treatment group was significantly higher than that of the control group (P <0.01), and the 3-year survival rate was higher than that of the control group (P <0.05). Conclusion Preoperative celiac arterial chemotherapy can induce apoptosis of gastric cancer cells in the late stage, reduce the proliferation activity of tumor cells, improve the curative resection rate and improve the survival rate of patients. Induced apoptosis of gastric cancer cells may be related to chemotherapy drugs to reduce the expression of Bcl-2 gene.