摘要
目的分析术前行短程放化疗或常规放化疗对ⅢB期直肠癌患者的手术效果及切除的组织标本中Runt相关转录因子3(Runx3)、细胞增殖核抗原Ki-67(简称Ki-67)表达的差异。方法前瞻性研究2019年1至12月于河北北方学院附属第一医院确诊的100例ⅢB期直肠癌患者的临床资料,其中男性52例、女性48例,年龄38~79(58.56±9.11)岁。将所有患者按电脑随机数字表法分为对照组和观察组,每组50例。对照组术前接受常规调强适形放疗+化疗,观察组术前接受短程放疗+化疗,分别比较2组患者手术的一般临床资料、术后病理T分期降期率、病理学完全缓解(pCR)率、不良反应发生情况、局部复发率、远处转移率和生存率,对切除的直肠癌组织标本采用免疫组化方法分别计算Runx3和Ki-67表达的评分。2组间计量资料的比较采用独立样本t检验;2组间的计数资料进行比较时,当例数<40或理论频数T≤1时采用Fisher's确切概率法,当例数≥40且理论频数T≥5(未校正)或1<T<5(校正)时采用χ^(2)检验。结果观察组与对照组患者的手术时间[(165.89±18.73)min对(158.14±23.57)min]、术中出血量[(215.63±56.89)mL对(227.84±60.75)mL]、术后排气时间[(62.28±16.47)h对(59.28±12.04)h]、住院时间[(13.97±7.11)d对(15.01±5.29)d]、吻合口瘘率[6%(3/50)对2%(1/50)]、肠梗阻率[4%(2/50)对0(0/50)]、感染率4%(2/50)对[8%(4/50)]的差异均无统计学意义(t=0.854~1.820,χ^(2)=0.260、0.177,Fisher's确切概率法,均P>0.05)。2组患者术后T分期降期率和pCR率的差异均无统计学意义(χ^(2)=0.160、0.000,均P>0.05)。观察组放射性皮炎总发生率(12%,6/50)低于对照组(30%,15/50),且差异有统计学意义(χ^(2)=4.883,P<0.05)。观察组术中切除标本中Runx3表达的评分为(2.56±0.51)分,高于对照组的(1.87±0.72)分,且差异有统计学意义(t=5.530,P<0.01),Ki-67表达的评分为(2.39±1.03)分,低于对照组的(3.94±0.46)分,且差异有统计学意义(
Objective To analyze the effect of preoperative short course radiotherapy and chemotherapy or conventional radiotherapy and chemotherapy on patients with stageⅢB rectal cancer and determine the differences in the expression of Runt-related transcription factor 3(Runx3)and cell proliferating nuclear antigen Ki-67(short for Ki-67)in the resected tissue specimens.Methods From January 2019 to December 2019,a prospective study was conducted on 100 patients with stageⅢB rectal cancer in the First Affiliated Hospital of Hebei North University,including 52 males and 48 females,aged 38–79(58.56±9.11)years.All patients were randomly divided into the control group and observation group,with 50 cases in each group.The control group received conventional radiotherapy+chemotherapy before operation,whereas the observation group received short-term radiotherapy+chemotherapy before operation.The operation-related conditions,postoperative pathological T staging reduction rate,pathological complete remission(pCR)rate,occurrence of adverse reactions,local recurrence rate,distant metastasis rate and survival rate were compared between the two groups.Immunohistochemical methods were used to detect the expression score of Runx3 and Ki-67 on the resected rectal cancer tissue samples.The measurement data of the two groups were compared using independent sample t test.When the number of cases was<40 or the theoretical frequency T≤1,Fisher's exact probability method was used.When the number of cases was≥40 and when the theoretical frequency was T≥5(uncorrection)or 1<T<5(correction),theχ^(2)test was used.Results The operation time((165.89±18.73)min),intraoperative blood loss((215.63±56.89)mL),postoperative exhaust time((62.28±16.47)h),hospitalization time((13.97±7.11)d),anastomotic leakage rate(6%,3/50),intestinal obstruction rate(4%,2/50)and infection rate(4%,2/50)in the observation group were compared with those in the control group(i.e.,(158.14±23.57)min,(227.84±60.75)mL,(59.28±12.04)h,(15.01±5.29)d,2%(1/50),0(0/50)
作者
高树全
张迎春
王胜杰
原娜
Shuquan Gao;Yingchun Zhang;Shengjie Wang;Na Yuan(Departmen of Hepatobiliary Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Radiotherapy,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)
出处
《国际放射医学核医学杂志》
2021年第3期155-161,共7页
International Journal of Radiation Medicine and Nuclear Medicine
