CAJ | 학술논문

目的探讨FOLFOX4方案新辅助化疗对结直肠癌并肝转移患者非瘤肝组织的影响.方法对42例结直肠癌并肝转移患者的肝手术切除标本进行检测分析,通过光镜、透射电镜观察非瘤肝组织的病理学变化并进行分级,应用半定量RT-PCR及Western blot检测非瘤肝组织中结缔组织生长因子(CTGF)表达状况.结果接受FOLFOX4方案新辅助化疗的19例患者中,12例(63.2%)可观察到非瘤肝组织损伤的组织形态学改变,包括小叶中央区肝窦严重扩张、红细胞淤滞、窦周纤维化和静脉闭塞纤维化等,而非化疗组23例患者均未观察到相应病变:新辅助化疗后非瘤肝组织中CTGF mRNA及蛋白质表达为2.347±1.104和3.021±1.735,分别高于对照组的0.825±0.302和0.982±0.326,差异具有统计学意义(P<0.01).结论转移性结直肠癌患者行全身FOLFOX4方案新辅助化疗可引起肝微血管系统的病理学改变,并通过诱导肝星状细胞产生CTGF而促进肝纤维化进程.
목적 탐토FOLFOX4방안신보조화료대결직장암병간전이환자비류간조직적영향.방법 대42례결직장암병간전이환자적간수술절제표본진행검측분석,통과광경、투사전경관찰비류간조직적병이학변화병진행분급,응용반정량RT-PCR급Western blot검측비류간조직중결체조직생장인자(CTGF)표체상황.결과 접수FOLFOX4방안신보조화료적19례환자중,12례(63.2%)가관찰도비류간조직손상적조직형태학개변,포괄소협중앙구간두엄중확장、홍세포어체、두주섬유화화정맥폐새섬유화등,이비화료조23례환자균미관찰도상응병변:신보조화료후비류간조직중CTGF mRNA급단백질표체위2.347±1.104화3.021±1.735,분별고우대조조적0.825±0.302화0.982±0.326,차이구유통계학의의(P<0.01).결론 전이성결직장암환자행전신FOLFOX4방안신보조화료가인기간미혈관계통적병이학개변,병통과유도간성상세포산생CTGF이촉진간섬유화진정.
Objective To investigate the effect of FOLFOX4 neoadjuvant chemotherapy on the non-tumoral liver in patients with metastatic colorectal carcinoma. Methods A large series of surgically resected liver metastases(n=42) was selected and the morphological changes were examined by light and electron microscope.The mRNA and protein levels of connective tissue growth factor(CTGF)expression were detected by semi-quantitative RT-PCR and Western blotting analysis. Results Twelve (63.2%) of the 19 post-chemotherapy liver resection specimens had sinusoidal dilatation and hemorrhage.In contrast,23 livers treated by surgery alone remained normal.Neoadjuvant chemotherapy could significantly enhance the mRNA and protein levels of CTGF expression in hepatic stellate cells. Conclusion Systemic FOLFOX4 neoadjuvant chemotherapy in metastatic colorectal carcinoma frequently causes morphoiotcal injuries involving hepatic microvasculature and induces CTGF expression in hepatic stellate cells to participate in hepatic fibrosis.