目的:探讨术前药物诱导性高压化疗治疗Ⅲ期贲门胃底癌的疗效和不良反应。方法:49例Ⅲ期贲门胃底癌患者随机分成观察组19例,对照组30例,术前均接受1周期化疗。观察组(IHC组)采用化疗+血管紧张素Ⅱ(ATⅡ),对照组(单纯化疗组)采用单纯化疗。两组患者均休息3周后接受手术。术后标本经流式细胞仪进行DNA分析。结果:观察组有效率63.2%(12/19),手术切除率84.2%(16/19),对照组有效率30.0%(9/30),手术切除率63.3%(19/30)。DNA倍体测定:观察组两倍体13例,异倍体5例;对照组两倍体9例,异倍体16例。两组患者均未增加手术并发症及手术风险。结论:术前药物诱导性高压化疗可明显提高Ⅲ期贲门胃底癌患者的疗效。开展IHC是一项很有前途的化疗途径,值得临床扩大实验。 Objective: To investigate the efficacy and adverse reactions of preoperative drug-induced high-pressure chemotherapy in the treatment of stage III gastric cardia cancer. Methods: Forty-nine patients with stage III gastric cardia cancer were randomly divided into observation group (n=19) and control group (n=30). All received preoperative chemotherapy. The observation group (IHC group) was treated with chemotherapy and angiotensin II (ATII), and the control group (single chemotherapy group) was treated with chemotherapy alone. Both groups received surgery after three weeks of rest. Postoperative specimens were subjected to DNA analysis by flow cytometry. RESULTS: The observation group had an effective rate of 63.2% (12/19), a surgical resection rate of 84.2% (16/19), a control group of 30.0% (9/30), and a surgical resection rate of 63.3% (19/30). DNA ploidy determination: There were 13 cases in the observation group and 5 cases in the aneuploid group; 9 cases in the control group and 2 cases in the aneuploid group. Both groups did not increase surgical complications and surgical risk. Conclusion: Preoperative drug-induced high pressure chemotherapy can significantly improve the efficacy of patients with stage III gastric cardia cancer. The development of IHC is a promising approach to chemotherapy and is worthy of clinical trials.