The Effect Of Compound Fluorouracil Polyphase Liposome Injection (FPLC) Injected In Rectal Submucosal In The Patients With Rectal Cancer On Apoptosis Of Rectal Cancer Cells

Objective: In order to evaluate the effect of Compound Fluorouracil Polyphase Liposome Injection injected in rectal submucosal in the patients with rectal cancer on apoptosis of rectal cancer cells.Methods: 40 patients with rectal cancer were randomly divided into two groups.In group Ⅰ(n1=20),patients were injected with FPLC for two times with each dose of 80mg (total dose 160mg) in rectal submucosal at 60h,36h before operation.In groupⅡ(n2=20),patients did not received any chemotherapy before operation.New sections from the paraffin blocks of the preoperative biopsies and surgical specimens of 2 groups of patients were examined for apoptosis using haematoxylin and eosin staining ,the expression of proliferating cell nuclear antigen (PCNA),Bcl-2,p53 protein by immunohistochemical staining.The effect of this treatment was judged by apoptotic index(AI),the positive rate of proliferating cell nuclear antigen expression(PI),the changes of positive expression of Bcl-2,p53 protein.At one time ,the injection sites in groupⅠand carcinomatous infiltration status of draining lymph nodes in 2 groups of patients after operation were pathologically examined.All statistical analyses were carried out using the SPSS 10.0 statistical package for Microsoft Windows.Results: In groupⅠ, Post-operation AI (2.505±0.838) was higher than that pre-operation (1.290±0.552) (P<0.001) , and post-operation PI (41.335±18.778) was lower than that pre-operation (45.755±21.478) (P<0.05); The Bcl-2,p53 protein positive expression after operation were both lower than those before operation(P<0.05); No side effect was found in all patients.But those were no obvious changes in group Ⅱ. AI in Dukes A+B patients before operation was higher than that in Dukes C+D patients (p<0.001), AI of the former was also significantly increased after chemotherapy (p<0.01); AI in well differentiated carcinoma was higher than poorly differentiated carcinoma (p<0.001), AI of the former was also significantly increased after chemotherapy (p<0.01). Lymph node positive rate in group Ⅰwas lower than controlled group in surgical specimens(11.72%vs22.54%,P<0.05.).Conclusion: 1. The treatment of FPLC injected in rectal submucosal can promote apoptosis of cancer cells, reduce their proliferation; it can also deregulate the expression of Bcl-2, p53 protein in tumor tissue; it can make obvious antitumor effect. 2. The earlier tumor in Dukes stage and the better carcinoma in tissue differentiation have better effect to this chemotherapy. 3. This chemotherapy can suppress cancer cells in regional lymph nodes of rectal cancer.