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新辅助化疗联合微创食管全系膜切除对食管中段鳞癌的疗效观察 被引量:1

Effects of neoadjuvant chemotherapy combined with minimally invasive total mesoesophageal excision on middle thoracic esophageal carcinoma
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摘要 目的探讨新辅助化疗联合食管全系膜切除(TME)治疗食管癌的临床效果,并观察新辅助化疗前后拓扑异构酶Ⅱ(TOPO-Ⅱ)、谷胱甘肽转移酶(GST-π)和多药耐药相关蛋白(MRP)表达水平的变化。方法选取90例食管中段鳞癌患者作为研究对象,并随机分为观察组和对照组,每组45例。观察组先进行2个周期紫衫醇+铂类(TP)方案新辅助化疗后行手术治疗;对照组同期直接进行手术治疗。观察比较两组手术时间、术中出血量、术后引流量和术后并发症发生情况,以及治疗后总有效率、淋巴结清扫数目、淋巴结组数、阳性淋巴结数等。应用免疫组化SP法检测DNA TOPO-Ⅱ、GST-π和MRP不同方案治疗前后的表达情况。结果观察组总有效率高于对照组(84.4%比60.0%,P〈0.05),且手术时间、术中出血量、术后引流量及术后并发症发生率少于对照组,差异有统计学义(P〈0.05)。观察组淋巴结清扫组数和食管各段淋巴结清扫个数多于对照组,且阳性淋巴结个数少于对照组,差异有统计学义(P〈0.05)。治疗前,两组患者TOPO-Ⅱ、GST-π和MRP的表达率比较差异未见统计学意义(P〉0.05);治疗后,观察组TOPO-Ⅱ的表达水平高于对照组,GST-π和MRP的表达水平低于对照组,差异有统计学义(P〈0.05)。结论新辅助化疗联合胸腔镜下食管全系膜切除治疗食管癌安全有效,TOPO-Ⅱ、GST-π和MRP的阳性表达率可作为判断新辅助化疗治疗食管癌有效性的指标。 Objective To investigate the clinical effects of neoadjuvant chemotherapy combined with total mesoesophageal excision (TME) on the treatment of esophageal cancer, and observe the expression levels of topoisomerase-Ⅱ (TOPO-Ⅱ), glutathione transferase (GST- π) and multidrug resistance-associated protein (MRP) before and after neoadjuvant chemotherapy.Methods Ninety patients with the middle thoracic esophageal carcinoma were selected as the research objects and were randomly divided into control group (45 cases) and observation group (45 cases). Patients in control group received conventional surgery, while patients in observation group were treated by neoadjuvant chemotherapy (taxol plus platinum) for two courses and then were treated by the same conventional surgery. The operation time, intraoperative blood loss, postoperative drainage volume and postoperative complications were observed and compared between the two groups. The total clinical effective rate and the number of dissected lymph node, the number of lymph node groups and the number of positive lymph nodes were compared between the two groups. Meanwhile, DNA TOPO-Ⅱ, GST-π and MRP were detected by immunehistochemical SP method before and after treatment in different regimens.Results The total effective rate of observation group was higher than that of control group (84.4% vs. 60.0%, P〈0.05), and the operation time, intraoperative blood loss, postoperative drainage and postoperative complications were less than those of control group, the difference was statistically significant (P〈0.05). The number of lymph node dissection groups and dissected lymph nodes in every segment of esophagus of observation group were more than those of control group, however, the number of positive lymph nodes in observation group was less than that in control group, the difference was statistically significant (P〈0.05). There was no significant difference in the levels of TOPO-Ⅱ, GST-π and MRP between the two groups befor
作者 李江红 王毅 姚烽 Li Jianghong, Wang Yi, Yao Feng(Department of Cardio-Thoracic Surgery, Heft Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Chin)
出处 《中国实用医刊》 2018年第5期54-57,共4页 Chinese Journal of Practical Medicine
关键词 新辅助化疗 食管全系膜切除 食管鳞癌 拓扑异构酶Ⅱ 多药耐药相关蛋白 谷胱甘肽转移酶 Neoadjuvant chemotherapy Total mesoesophageal excision Esophageal squamous cell carcinoma Topoisomerase-II Muhidrug resistance-associated protein Glutathione transferase
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