摘要
目的探讨新辅助放化疗联合全直肠系膜切除术(TME)术对ⅢB期直肠癌组织内RUNX3、Survivni、ki-67的影响。方法纳入我院2018年1月至2019年1月收治的ⅢB期直肠癌患者100例。根据随机数字表法分成实验组、对照组,各50例。实验组患者于术前行短程放、化疗,并行TME术,对照组患者术前不予以放、化疗;两组患者术后常规行放、化疗。两组均在入院时及TME术中取病理组织,经免疫组化法检测肿瘤组织内RUNX3、Survivni、ki-67的表达情况,并分析各指标表达与新辅助治疗疗效的关系。记录两组12个月内的生存率,分析治疗期间不良反应率、术后并发症率。结果实验组的RUNX3阳性率显著高于入院时,Survivni、ki-67阳性率显著低于入院时(P<0.05)。实验组TME术中RUNX3阳性率较对照组显著增高,Survivni、ki-67阳性率较对照组明显下降(P<0.05)。缓解组RUNX3阳性率显著高于未缓解组,Survivni、ki-67阳性率显著低于未缓解组(P<0.05)。实验组术后12个月的生存率为90.00,显著高于对照组的74.00%(P<0.05)。两组肝脏毒性、恶心呕吐、白细胞下降、血小板下降、骨髓抑制、放射性皮炎发生率比较,差异均无统计学意义(P>0.05)。两组切口感染、吻合口漏、肠梗阻、切口脂肪液化等并发症发生率比较无统计学差异(P>0.05)。结论ⅢB期直肠癌患者术前短程放、化疗,能降低Survivni、ki-67阳性率,提升RUNX3阳性率,且未增加不良反应风险,临床应用价值较高。
Objective To explore the effect of neoadjuvant radiotherapy and chemotherapy combined with TME on RUNX3,survivni and Ki-67 inⅢB stage rectal cancer.Methods 100 patients with stageⅢB rectal cancer admitted to our hospital from January 2018 to January 2019 were included.According to the method of random number table,50 cases were divided into experimental group and control group.Patients in the experimental group received short-range radiotherapy and chemotherapy and TME operation before surgery,while patients in the control group received no radiotherapy and chemotherapy before surgery.Postoperative routine radiotherapy and chemotherapy were performed in the two groups.Pathological tissues were taken from both groups at admission and during TME,The expressions of RUNX3,Survivni and ki-67 in tumor tissues were detected by immunohistochemistry,and the relationship between the expression of each indicator and clinical efficacy was analyzed.The therapeutic effect,adverse reactions and postoperative complications were recorded.Results The positive rate of RUNX3 in the experimental group was significantly higher than that in the admission,and the positive rate of survivni and Ki-67 was significantly lower than that in the admission(P<0.05).The positive rates of RUNX3 and survivni,Ki-67 in TME group were significantly higher than those in control group(P<0.05).The 12-month survival rate of the experimental group was 90.00,significantly higher than that of the control group(74.00%)(P<0.05).There was no statistically significant difference in the incidence of hepatotoxicity,nausea and vomiting,decreased white blood cells,decreased platelets,bone marrow suppression,and radioactive dermatitis between the two groups(P>0.05).There was no statistical difference in the incidence of incision infection,anastomotic leakage,intestinal obstruction,incision fat liquefaction and other complications between the two groups(P>0.05).ConclusionⅢphase B preoperative short put,chemotherapy,patients with rectal cancer can reduce Survivni
作者
高树全
张迎春
张超
王胜杰
任伟
原娜
温军业
GAO Shu-quan;ZHANG Ying-chun;ZHANG Chao;WANG Sheng-jie;REN Wei;YUAN Na;WEN Jun-ye(The First Affiliated Hospital of Hebei North University,Gastrointestinal surgery,,075000;The First Affiliated Hospital of Hebei North University,Hepatobiliary surgery,075000)
出处
《现代消化及介入诊疗》
2020年第9期1146-1150,共5页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
河北省卫生厅科研基金项目(20180813)
张家口市科技攻关计划项目(1921132H)。
