The Basic And Clinical Research Of Preoperative Transcather Arterial Chemoembolization On Wilms' Tumor Patients

Objective: We study the apoptosis, proliferating cell nuclear antigen(PCNA), Vascular endothelial growth factor(VEGF), P-glycoprotein(P-gp) expressed by nephroblastoma cell and the effect on the tumor by preoperative transcather arterial chemoembolization(TACE) in order to discuss a new method of treating Wilms'tumor and improve the ratio of comply resection and the prognosis. Method: (1)According to the clinical stage and histology, put the 24 patients of Wilms'tumor on TACE group and chemotherapy group, and each group have 12 patients.(2)After 2 weeks of the end of the therapy, using CT to determine the ratio of tumor size change, estimating the ratio of tumor liquefaction and necrosis and the transferred lymph node through operation, using bone marrow centesis to analysis the bone marrow depression, to learn the two methods effect on clinic tumor therapy.(3)By using TENUL method to estimate the apoptosis index of tumor cell and the Monoclonal Antibody method to estimate the index and class of PCNA, to learn the effect on cell apoptosis and proliferation after preoperative therapy.(4)By using Monoclonal Antibody method to estimate the class of VEGF, to learn the none-apoptosis cells' ability of proliferation, transformation and invasion after preoperative therapy.(5)By using the Monoclonal Antibody method to estimate the class of VEGF, to learn the drug resistance of tumor cell afterpreoperative therapy.Result:(1)In the ratio of tumor size change, liquefaction and necrosis, TACE group is higher than chemotherapy group(p<0.05), but the ratio of controlled transferred lymph node seem no difference with chemotherapy group(p>0.05), and the none-completely cure or tumor rupture rate, the bone marrow depression rate are lower than chemotherapy group(P<0.05).(2)In cell apoptosis index, TACE group is higher than chemotherapy group(P<0.05), while in cell PCNA expression, TACE group is lower than chemotherapy group(P<0.05).In each group, the AI and PI have a negative correlation(P<0.05).(3)In tumor cell VEGF expression TACE group is higher than chemotherapy group(P<0.05). (4) In tumor cell P-gp expression ,TACE group is higher than chemotherapy group(P<0.05). Conclusion:(1)Compare with chemotherapy, preoperative TACE can make the WT's tumor size change smaller in a short time and the ratio of liquefaction and necrosis is higher, it can be easier to resect tumor completely and decrease the ratio of tumor rupture.(2)Compare with chemotherapy, preoperative TACE has more efficiency on inducing tumor cell apoptosis and restraining cell proliferation.(3) Compare with chemotherapy, after preoperative TACE, the remnant tumor cells have a higher ability to proliferate, transfer and invade. (4) Compare with chemotherapy, after preoperative TACE, the tumor cells have higher ability to resist the drug of chemotherapy.