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目的 探讨肾母细胞瘤术前化疗疗效规律及耐药性的生物学特性 ,确认其术前化疗的合适疗程。方法 选择 15例按L化疗方案接受术前化疗 5周以上、资料记录完整的患儿作为术前化疗疗效研究对象 ,测量术前化疗不同疗程肿瘤大小 ;对 18例未术前化疗和经不同疗程术前化疗病理档案 ,采用JSD 单克隆抗体对肾母细胞瘤组织多药耐药蛋白 (P glycoprotein ,P gp)进行免疫组织化学检测 ,了解P gp在术前化疗不同疗程的表达特点。 结果 术前化疗 2周后 ,肿瘤体积缩小值最明显 ,术前化疗 4周后 ,其体积缩小值减缓 ,部分病例有逐渐增大趋势 ;而术前化疗疗程越长 ,肿瘤细胞P gp表达越强。 结论 L术前化疗方案对肾母细胞瘤的疗效肯定 ,疗程以 2～ 3周后最显著。其疗效降低可能与术前化疗后瘤组织对化疗药物耐药性明显增强有关。合适疗程为 3～ 4周
Objective To investigate the biological characteristics of preoperative chemotherapy and drug resistance of nephroblastoma and to confirm the appropriate course of preoperative chemotherapy. Methods Fifteen patients undergoing preoperative chemotherapies for more than 5 weeks undergoing L chemotherapy regimen were enrolled in this study. Patients with complete data records were used as preoperative chemotherapeutic agents to measure the tumor size in different courses of preoperative chemotherapy. Eighteen patients without preoperative chemotherapy and with different courses of treatment Preoperative chemotherapy pathology files, the use of JSD monoclonal antibody on nephroblastoma multi-drug resistance protein (P gp) immunohistochemical detection of P gp in the preoperative chemotherapy of different stages of the expression characteristics. Results Two weeks after preoperative chemotherapy, the size of the tumor was the most obvious. After 4 weeks of preoperative chemotherapy, the volume of the tumor decreased gradually and some cases showed a trend of increasing gradually. However, the longer the preoperative chemotherapy, the more the expression of Pgp Strong. Conclusion L preoperative chemotherapy regimen for the treatment of nephroblastoma affirmation, the treatment of 2 to 3 weeks after the most significant. The curative effect may be related to the preoperative chemotherapy tumor tissue chemoresistance significantly increased. The appropriate course of treatment is 3 to 4 weeks