| Objective To investigate the expression of apoptosis included Fas and Survivin ofspecimen collected from colorectal caner surgery after neo-adjuvantchemotherapy. To explore the effect of apoptosis of colorectal caner cellwhich were inducted by neo-adjuvant chemotherapy and evaluate theeffect and meaning of the therapy that neo-adjuvant chemotherapycontributed to colorectal caner cell.Methods Our collected the tumor tissue (26 cases) gathered from laparoscopiccolorectal caner surgery(LAC) in Wuhan union hospital during April2008 to April 2009. The sample were divide into two groups: neo-adjuvantchemotherapy group (NACT group) including 9 cases and LAC groupincluding 17 cases, otherwise blank control group which specimen comefrom the normal colorectal tissue far away to cancer including 10 cases.The approach of S-P immunohistochemistry probed the expression of Fasantigen in the specimens; moreover Western Bolt detected the expressionof Survivin. The statistics method used ?2, ANOVAand t-test to evaluatestatistic significance.Result The expression of Fas respectively was 24%(4/17), 67%(6/9), 60%(6/10)inLAC group, NACT group, blank control group. The Fas positiveexpression of NACT group wasn't only apparently higher than the surgerygroup, but also had statistic significance (P<0.05). The expression ofSurvivin in surgery group, NACT group, blank control group respectivelywas 86.9%±1.7%, 53.8%±4.7%, 19.9%±2.5%. Furthermore, all three group have conspicuously statistic significance in difference on theexpression of Survivin (P<0.05). It separately to compare NACT groupwith LAC group also had conspicuouslystatistic significance (P<0.05).Conclusion Neo-adjuvant chemotherapy could up-regulate the expression of Fas inthe cell of colorectal cancer, and down-regulate the expression of Survivin.That result indicates the tumor cell increasing the level of apoptosis andthe prognosis of colorectal cancer was a better improvement. So theneo-adjuvant chemotherapy would promote colorectal cancer cell todeath,and decreased tumor cell proliferation.Objective To explore clinical value of preoperative regional intra-arterialchemotherapy (PRAC) combined with laparoscopic colorectal surgeryin thetherapyof colorectal cancer including safetyand efficacy.Methods Our hospital conduct a prospective controlled trial towards thecomprehensive treatment of colorectal cancer during July 2004 to July2007.The 61 cases of colorectal cancer in 5 years treated with laparoscopicsurgery were random divided into PRAC+LAC group (23cases) and LACgroup to observe complications of chemotherapy and to compare the surgery time, blood loss, bowel movement time, oral diet time, lymph nodemetastasis rate, complications of surgery, hospital charge and so on. It usedKaplan-Meier method to estimate 1, 3, 5 years survival rate and mediansurvival time and Log-Rank to compare survival curve between twogroup(α=0.05).Results In all 23 PRAC cases total complication rate was 21.7%, and all patientsdidn't bring about some serious complications as perforation or hemorrhage.The short-term outcomes between two groups in surgery time, bowlmovement time, oral diet time, lymph node metastasis rate and the totalcomplication rate in 30 days post-operation had no statistic significance. TheLAC group(246.7±90.4) ml was higher than the PRAC+LAC group(152.5±46.9)ml on blood loss, but the LAC group (2.8±1.1) ten thousand RMBwas lower than PRAC+LAC group on the hospital charge. The results aboveboth had apparently statistic difference. On the long-term outcomes of PRAC,the accumulative survival rate of 1, 3, 5 years and the median survival timerespectively was 86.8%, 31.9%, 18.2%, 24month in LAC group and 91.3%,58.4%, 36.5%, 42month in PRAC+LAC group. The difference had obviousstatistic significance between the survival curves of the two groups(P<0.05).Conclusion Preoperative regional intra-arterial chemotherapy combined withLaparoscopic colorectal surgery in treating colorectal cancer had a minimaltoxicityof chemotherapy and no addition to the risk of surgery. It had a bettershort-term outcome and also a satisfying long-term outcome; the therapywould increase survival rate of the patient and median survival time,therefore it possessed better clinical value.
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