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目的探讨术前新辅助治疗对低位直肠癌p33ING1表达及细胞凋亡、保肛的影响。方法60例低位直肠癌病例随机分为两组,均给予术前新辅助放疗。A组放疗前先行新辅助化疗。检测两组治疗前及手术后的p33ING1表达及细胞凋亡,观察其保肛情况。结果全部病例按计划完成新辅助放化疗并施行根治性切除术。A组治疗前后p33ING1阳性表达分别为43.33%和76.67%,B组分别为46.67%和60.00%,差异有显著性(P<0.01)。A组治疗前后凋亡指数(apoptosis Indexes,AI)分别为(8.90±1.10)‰和(55.83±1.01)‰,B组分别为(8.82±1.12)‰和(28.56±1.06)‰,差异有显著性(P<0.01)。两组治疗前p33 ING1阳性表达、AI之间无明显差异,术后则差异有显著性(P<0.01)。A组全部保肛成功,B组保肛24例,差异有显著性(P<0.05)。结论低位直肠癌术前采用新辅助治疗可以增高p33ING1表达、促进癌细胞凋亡、提高保肛率,它是对低位直肠癌治疗的有效和合理的措施。
Objective To investigate the effect of preoperative neoadjuvant therapy on the expression of p33ING1, apoptosis and anal sphincter preservation in low rectal cancer. Methods Sixty cases of low rectal cancer were randomly divided into two groups, all given preoperative neoadjuvant radiotherapy. Group A received neoadjuvant chemotherapy before radiotherapy. The p33ING1 expression and apoptosis in both groups before and after the operation were detected and the anal sphincter preservation was observed. Results All cases completed neoadjuvant chemoradiation and radical resection as planned. The positive expression of p33ING1 in group A before and after treatment was 43.33% and 76.67% respectively, while in group B it was 46.67% and 60.00%, respectively. The difference was significant (P <0.01). The apoptotic indexes (AI) in group A before and after treatment were (8.90 ± 1.10) ‰ and (55.83 ± 1.01) ‰, respectively, and those in group B were (8.82 ± 1.12) ‰ and (28.56 ± 1.06) ‰, respectively (P <0.01). There was no significant difference between the two groups before p33 ING1 expression, but the difference was significant after operation (P <0.01). All anal sphincter preservation was successful in group A, and there were 24 cases of anal sphincter preservation in group B, the difference was significant (P <0.05). Conclusions Neoadjuvant treatment of low rectal cancer preoperatively can increase the expression of p33ING1, promote the apoptosis of the cancer cells and improve the anal sphincter preservation rate. It is an effective and reasonable measure for the treatment of low rectal cancer.