CAJ | 학술논문

目的：检测大肠癌患者根治术中植入氟尿嘧啶植入剂后外周血survivin、caspase-3、CD44V6的变化，探讨其对肿瘤微转移及预后的影响。方法64例大肠癌患者（Dukes B期、C期）随机分为治疗组和对照组，每组32例。2组均行标准根治术，治疗组术中植入氟尿嘧啶植入剂；对照组术中未应用此药。采用RT-PCR方法测定手术前后外周血中survivin、caspase-3表达水平，流式细胞术检测CD44V6含量。结果术前2组survivin、caspase-3、CD44V6的水平差异无统计学意义（P＞0.05）；术后14 d，治疗组survivin水平（0.362±0.183）低于对照组（0.585±0.207），caspase-3水平（2.001±0.146）高于对照组（1.654±0.111）；术后CD44V6水平治疗组（1.857±0.535）和对照组（3.471±0.496）明显低于术前的（9.557±1.170）和（9.729±0.943），且治疗组CD44V6水平低于对照组（均P＜0.05）。结论术中植入氟尿嘧啶植入剂，对大肠癌的微转移及预后有重要意义，有望提高大肠癌术后的远期疗效。
목적：검측대장암환자근치술중식입불뇨밀정식입제후외주혈survivin、caspase-3、CD44V6적변화，탐토기대종류미전이급예후적영향。방법64례대장암환자（Dukes B기、C기）수궤분위치료조화대조조，매조32례。2조균행표준근치술，치료조술중식입불뇨밀정식입제；대조조술중미응용차약。채용RT-PCR방법측정수술전후외주혈중survivin、caspase-3표체수평，류식세포술검측CD44V6함량。결과술전2조survivin、caspase-3、CD44V6적수평차이무통계학의의（P＞0.05）；술후14 d，치료조survivin수평（0.362±0.183）저우대조조（0.585±0.207），caspase-3수평（2.001±0.146）고우대조조（1.654±0.111）；술후CD44V6수평치료조（1.857±0.535）화대조조（3.471±0.496）명현저우술전적（9.557±1.170）화（9.729±0.943），차치료조CD44V6수평저우대조조（균P＜0.05）。결론술중식입불뇨밀정식입제，대대장암적미전이급예후유중요의의，유망제고대장암술후적원기료효。
Objectives To observe the pre and post-operational changes of the expressions of survivin, caspase-3 and CD44V6 in patients with colorectal cancer after intra-abdominal implantation of sustained releasing fluorouracil. Meth-ods Sixty-four patients with colorectal cancer (Dukes’stage of B and C) were divided into treatment group and control group, 32 patients in each group. The standard radical surgery was performed in two groups of patients. The fluorouracil im-plants were implanted intra-abdominally in treatment group. The peripheral blood levels of surviving and caspase-3 were de-tected by RT-PCR. The level of CD44V6 was detected by flow cytometry in two groups of patients. Results There were no significant differences in levels of survivin, caspase-3 and CD44V6 before surgery between two groups (P>0.05). The level of survivin (0.362 ± 0.183) was significantly lower at 14 days after operation in treatment group than that of control group (0.585±0.207), but the level of caspase-3 (2.001±0.146) was significantly higher than that of control group (1.654±0.111). The levels of CD44V6 were significantly lower in treatment group (1.857±0.535) and control group (3.471±0.496) after opera-tion than those before operation (9.557±1.170 and 9.729±0.943, P<0.05), and the level of CD44V6 was significantly lower in treatment group than that of control group (P<0.05). Conclusion The implant for the sustained release of fluorouracil showed a positive impact on micrometastases and prognosis of colorectal cancer, while improved the long-term efficacy of postoperative colorectal cancer.