中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
38期
2684-2688
,共5页
金建华%戎亚雄%王芳%许锡元%陆文斌%李献文%邓建中%张华%徐学忠%薛志新
金建華%戎亞雄%王芳%許錫元%陸文斌%李獻文%鄧建中%張華%徐學忠%薛誌新
금건화%융아웅%왕방%허석원%륙문빈%리헌문%산건중%장화%서학충%설지신
直肠肿瘤%放射疗法,计算机辅助%PTEN磷酸水解酶%新辅助放化疗
直腸腫瘤%放射療法,計算機輔助%PTEN燐痠水解酶%新輔助放化療
직장종류%방사요법,계산궤보조%PTEN린산수해매%신보조방화료
Rectal neoplasms%Radiotherapy,computer-assisted%PTEN phosphohydrolase%Neoadjuvant chemoradiotherapy capecitabine
目的 探讨术前口服卡培他滨与放疗联合治疗对低位直肠癌的疗效及磷酸酶与张力蛋白同源物(PTEN)蛋白在此过程中的表达变化.方法 66例低位直肠癌患者均给予术前新辅助放化疗:口服卡培他滨1650 mg·m-2·d-1分两次服用,总服药2个疗程;化疗同时开始体外放疗,2 Gy/d,每周治疗5 d,总剂量为50 Gy.观察术前新辅助放化疗的疗效,并应用反转录-聚合酶链反应(RT-PCR)和Western印迹技术检测患者PTEN的表达变化.结果 92.4%(61/66)的患者按计划完成新辅助放化疗.87.9%(58/66)的患者肿瘤分期降级,癌灶范围缩小距肛缘的距离增大.所有患者均施行根治性切除术,保肛率达90.9%(60/66),85.5%的患者肛门括约肌功能良好.随访发现患者术后2年生存率为87.9%(58/66),仍然健在患者的生存期25～60个月,平均35.3个月;PTEN mRNA和蛋白在新辅助治疗前直肠癌组织中表达量均明显低于手术后直肠癌组织(P=0.0079、0.0269).结论 低位直肠癌术前采用术前新辅助放化疗确实能达到肿瘤降期、提高手术切除率和保肛成功率等目的,增加PTEN表达、促进癌细胞凋亡、取得了较高的生存率,是治疗低立直肠癌的一种有效辅助措施.
目的 探討術前口服卡培他濱與放療聯閤治療對低位直腸癌的療效及燐痠酶與張力蛋白同源物(PTEN)蛋白在此過程中的錶達變化.方法 66例低位直腸癌患者均給予術前新輔助放化療:口服卡培他濱1650 mg·m-2·d-1分兩次服用,總服藥2箇療程;化療同時開始體外放療,2 Gy/d,每週治療5 d,總劑量為50 Gy.觀察術前新輔助放化療的療效,併應用反轉錄-聚閤酶鏈反應(RT-PCR)和Western印跡技術檢測患者PTEN的錶達變化.結果 92.4%(61/66)的患者按計劃完成新輔助放化療.87.9%(58/66)的患者腫瘤分期降級,癌竈範圍縮小距肛緣的距離增大.所有患者均施行根治性切除術,保肛率達90.9%(60/66),85.5%的患者肛門括約肌功能良好.隨訪髮現患者術後2年生存率為87.9%(58/66),仍然健在患者的生存期25～60箇月,平均35.3箇月;PTEN mRNA和蛋白在新輔助治療前直腸癌組織中錶達量均明顯低于手術後直腸癌組織(P=0.0079、0.0269).結論 低位直腸癌術前採用術前新輔助放化療確實能達到腫瘤降期、提高手術切除率和保肛成功率等目的,增加PTEN錶達、促進癌細胞凋亡、取得瞭較高的生存率,是治療低立直腸癌的一種有效輔助措施.
목적 탐토술전구복잡배타빈여방료연합치료대저위직장암적료효급린산매여장력단백동원물(PTEN)단백재차과정중적표체변화.방법 66례저위직장암환자균급여술전신보조방화료:구복잡배타빈1650 mg·m-2·d-1분량차복용,총복약2개료정;화료동시개시체외방료,2 Gy/d,매주치료5 d,총제량위50 Gy.관찰술전신보조방화료적료효,병응용반전록-취합매련반응(RT-PCR)화Western인적기술검측환자PTEN적표체변화.결과 92.4%(61/66)적환자안계화완성신보조방화료.87.9%(58/66)적환자종류분기강급,암조범위축소거항연적거리증대.소유환자균시행근치성절제술,보항솔체90.9%(60/66),85.5%적환자항문괄약기공능량호.수방발현환자술후2년생존솔위87.9%(58/66),잉연건재환자적생존기25～60개월,평균35.3개월;PTEN mRNA화단백재신보조치료전직장암조직중표체량균명현저우수술후직장암조직(P=0.0079、0.0269).결론 저위직장암술전채용술전신보조방화료학실능체도종류강기、제고수술절제솔화보항성공솔등목적,증가PTEN표체、촉진암세포조망、취득료교고적생존솔,시치료저립직장암적일충유효보조조시.
Objective To explore the expression of phosphatase and tensin homolog deleted on chromosometen (PTEN) in low rectal cancer on neoadjuvant chemoradiotherapy with capecitabine plus week). Then the investigators analyzed the relationship between the preoperative neoadjuvant chemoradiotherapy and prognosis and measured the expression of PTEN during neoadjuvant chemoradiotherapy. Results 92.4% (61/66) of patients received neoadjuvant chemoradiotherapy as planned. 87.9% (58/66)tumor stages were down-staged, tumor size decreased while the distance from analedge increased. And curative resection with sphincter-sparing was carried out in all patients. The rate of sphincter preservation was 90.9% (60/66). Among which, 85.5% patients showed an excellent function of sphincter. The 2-year survival rate was 87.9% (58/66). The survival period was an average of 35.3 months (range: 25 -60). The PTEN mRNA and protein expression in cancer tissues on neoadjuvant chemoradiotherapy were significantly higher than those before neoadjuvant chemoradiotherapy (P= 0.0079,0.0269). Conclusions The preoperative neoadjuvant chemoradiotherapy in lower rectal cancer patients has shown its efficacy in down-staging cancer, enhancing resectability, offering sphincter preservation, upregulating PTEN expression, promoting the apoptosis of cancer cell and achieving a better survival rate. Thus preoperative neoadjuvant chemoradiotherapy is an effective adjuvant measure.
