| Objective: Apoptosis is the name given to programmed cell death , which plays an important role in modulation of the development, morphogenesis and maintenance of homeostasis in normal tissues. Moreover, apoptosis plays a crucial role in the proliferation and differentiation of cell in various tumors. Recently further research testified that apoptosis and proliferation of gastric carcinoma cells are significantly correlated with tumor infiltration, lymph node metastasis and prognosis. The experimental study suggests that anticancer drugs such as cisplatin, cytarabine or mitomycin can induce apoptosis. Thus it is believed that apoptosis might be important in cancer chemotherapy. Present studies aim to investigate the effect of preoperative treatment with 5-fluorouracil on apoptosis and proliferation activity of gastric carcinoma cells, and to evaluate the chemotherapeutic effect of anticancer drug from the perspective of inducing tumor cell apoptosis and suppressing tumor cell proliferation, and moreover, to offer theoretical proof for clinicalapplication of preoperative chemotherapy with 5-Fluorouracil.MethodsrContinuous intravenous infusion of 5-Fluorouracil was given in thirty patients withadvanced gastric adenocarcinoma at 750mg /body/weight/day for 5 days preoperatively. Tumors were obtained immediately after operation as postchem-otherapy samples. Based on self-comparison principle, biopsy tissues of gastric cancer tissues during endoscope examination preoperatively were obtained as prechemotherapy controls. The percentage of apoptotic cells w7ere examined by terminal deoxynudeotidyl-transferase (TDT)-mediated deoxyuridine tripyosphate biotion nick end labeling (TUNEL) method and was recorded as apoptosis index. Proliferation activity was detected by immunohistochemical staining and was recorded as proliferation index. The results of prechemotherapy or postchemotherapy were compared with clinicopathology of the patients.Results: Effect of 5-Fluorouracil on apoptosis of gastric cancer: The general apoptosis index (AI) was 6.9+3.0% in the gastric cancers before chemotherapy, and 10.1+5.2% in those after chemotherapy. Significant difference was found between two groups(P<0.05). Before the chemotherapy, average AI was 8.8+2.7% in 15 well-differentiated gastric adenocarcinomas, 4.5+1.2% in 12 poorly differentiated gastric adeno-carcinoms, and 6.3+1.6% in 3 mucous gastric adenocarcinomas. Significant difference was found between well-differentiated adenocarcinomas and poor-differentiated adenocarcinomas (P<0.05). Average AI was 7.1+3.3% in 14 small tumors with maximum diameter less than 4 centimeter, but 5.8+2.1% in 16 larger tumors diameter with maximum diameter more than 4 centimeter, and no significant differences was found .between them(P>0.05). Average AI was 8.5+2.8% in 11 cases with no serosa invasion of cancer , but 6,8+2.5% in 19 cases with serosa invasion of cancer, and no significant difference was found between them(P>0.05).After chemotherapy, Average AI was 14.1+3.4% in well-differentiated adenocarcinomas, 5.1+1.3% in poor-differentiated adenocarcinomas, and 6.5+2.0% in mucous adenocarcinomas. Significant difference was found between the AI before chemotherapy and that after chemotherapy in the well-differentiated adeno-carcinoma groups (P<0.01), but not in poor-differentiated groups (P>0.05)and mucous adeno-carcinoma groups(P>0.05). After chemotherapy, Average AI was 11.1+5.2% in tumors with maximum diameter less than 4 centimeter, but 7.3+4.5% in tumors with maximum diameter more than 4 centimeter.Significant differences was found between the AI before chemotherapy and that after chemotherapy in groups of tumor with maximum diameter less than 4 centimeter(P<0.01), but not in groups of those withmaximum diameter more than 4 centimeter(P>0.05).After chemotherapy, average AI was 13.2+4.2% in tumors with serosa not invaded, but 7.6+4.0% in those with serosa invaded. Significant differences was found between the AI before chemoth... |
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