CAJ | 학술논문

目的探讨术前动脉化疗栓塞对膀胱癌细胞增殖和凋亡及肿瘤血管生成相互关系的影响及临床意义.方法分别选取术前行动脉化疗栓塞及同期单纯手术治疗的膀胱癌患者50例(观察组)、30例(对照组),采用EliVision二步法检测Ki-67的表达情况,细胞凋亡检测应用DNA末端标记法(Tunel法),计算凋亡指数(AI)、增殖指数(LI)和微血管密度计数(MVD).比较两组患者的3年生存率和复发率.分析观察组患者化疗栓塞前后AI、LI、MVD的变化及其与患者预后的关系.结果两组患者3年生存率的差异无统计学意义(P>0.05),观察组3年复发率显著低于对照组(P<0.01).观察组患者栓塞后MVD及LI显著下降、AI显著升高(均P<0.01),其中高分级、浸润性及初发患者栓塞后MVD及LI明显下降、AI显著升高,复发患者仅MVD明显下降,差异均有统计学意义(P<0.05或0.01).AI与LI、MVD呈负相关(P<0.01),LI与MVD呈正相关(P<0.01).观察组中复发与未复发者栓塞前后MVD的差异均有统计学意义(均P<0.05),未复发者栓塞后LI显著下降、AI显著升高(P<0.01);生存者栓塞后MVD、LI明显下降、AI显著升高,差异均有统计学意义(P<0.05或0.01).结论细胞的增殖和凋亡状况、微血管密度可作为膀胱癌的预后评估指标.术前动脉化疗栓塞可以明显降低膀胱癌组织的LI和MVD,增高AI,调节膀胱癌的分化程度,降低复发率.
목적탐토술전동맥화료전새대방광암세포증식화조망급종류혈관생성상호관계적영향급림상의의.방법분별선취술전행동맥화료전새급동기단순수술치료적방광암환자50례(관찰조)、30례(대조조),채용EliVision이보법검측Ki-67적표체정황,세포조망검측응용DNA말단표기법(Tunel법),계산조망지수(AI)、증식지수(LI)화미혈관밀도계수(MVD).비교량조환자적3년생존솔화복발솔.분석관찰조환자화료전새전후AI、LI、MVD적변화급기여환자예후적관계.결과량조환자3년생존솔적차이무통계학의의(P>0.05),관찰조3년복발솔현저저우대조조(P<0.01).관찰조환자전새후MVD급LI현저하강、AI현저승고(균P<0.01),기중고분급、침윤성급초발환자전새후MVD급LI명현하강、AI현저승고,복발환자부MVD명현하강,차이균유통계학의의(P<0.05혹0.01).AI여LI、MVD정부상관(P<0.01),LI여MVD정정상관(P<0.01).관찰조중복발여미복발자전새전후MVD적차이균유통계학의의(균P<0.05),미복발자전새후LI현저하강、AI현저승고(P<0.01);생존자전새후MVD、LI명현하강、AI현저승고,차이균유통계학의의(P<0.05혹0.01).결론세포적증식화조망상황、미혈관밀도가작위방광암적예후평고지표.술전동맥화료전새가이명현강저방광암조직적LI화MVD,증고AI,조절방광암적분화정도,강저복발솔.
Objective To investigate the cel proliferation, apoptosis and tumor angiogenesis of bladder cancer after tran-scatherter arterial chemoembolization (TACE). Methods The apoptosis index (AI),proliferation index (LI) and microvessel den-sity (MVD) of cancer tissue were examined by immunohistochemistry in 50 bladder cancer patients before and after chemoem-bolization (TACE group) and in 30 patients with surgical treatment (control group). The 3-y survival rates and recurrence rates were compared between two groups. The correlation of cancer cel proliferation, apoptosis and MVD before and after chemoem-bolization with postoperative survival and the recurrence was analyzed. Results There was no significant difference in 3-y sur-vival rate between two groups (P>0.05). The 3-year recurrence rate in TACE group was significantly lower than that in control group(P<0.01). AI was increased significantly after chemoembolization, while MVD and LI were decreased significantly(P<0.01), especial y for the high grade, invasive or incipient patients. But the relapsing patients had only decline of MVD. AI was negatively correlated with MVD and LI (P<0.01), while LI was positively correlated with MVD (P<0.01). There was significant difference in MVD of cancer tissue between relapsed group and non-relapsed group both before and after chemoembolization. LI declined significantly, while AI increased significantly in non-relapsed group after chemoembolization (P<0.01). Conclusion The cancer cel proliferation, apoptosis and microvessel density may be used as indicators in assessing prognosis for bladder cancer. Pre-operative chemoembolization can decrease LI and MVD and increase apoptosis rate in bladder cancer tissue, resulting in the decrease of recurrence rate.