Preliminary Study Of Gastric Cancer In Regional Arterial Hyperthermic Chemotherapy Mechanism And Clinical Observation

Objective:To evaluate the effect of the expressions of Ki-67 and VEGF in Gastric cancer cells by Intra-operataive Reginal Arterial Perfusion Thermochemotherapy(RAC).Methods: During radical resection of gastric cancer, patients were underwent the treatment of regional arterial perfusion thermochemotherapy with the 100ml heated(43-44℃) normal sodium including 5-Fu(1000mg/m2),MMC(10mg/m2) and 2ml methylene blue injection.The expression of Ki-67 and VEGF, in 30 cases of gastric carcinoma, before and after the treatment of intra-operative RAC was examined by SP immunohistochemical method.Results: After the Intra-operative Regional Arterial Perfusion Chemotherapy,the expression of Ki-67 was lower than preopertive, from 60.5% to 39.2% ,and the difference was significant ( P<0.05). After the Intra-operative Regional Arterial Perfusion Chemotherapy,the expression of VEGF was lower than preopertive, from 46.1% to 25.6% ,and the difference was significant ( P<0.05).Conclusion:The intra-operative RAC in patients with gastric carcinoma can obviously depress the expressions of Ki-67 and VEGF. So it has significance in preventing intra-operational extension and postoperative recurrence. Objective: To observe the characteristics during operation, histopathological change and influence to patients after regional arterial perfusion thermochemotherapy during radical resection of gastric carcinoma.Methods: Treated group were underwent the treatment of regional arterial perfusion thermochemotherapy with the 100ml heated(43-44℃) normal sodium including 5-Fu(1000mg/m2),MMC(10mg/m2) and 2ml methylene blue injection.Contral group was not treated by regional arterial perfusion thermochemotherapy.And afterwards the characteristics during operation, histopathological change of tumor, function of liver and renal one and four day after operation, blood routine and ECG, reaction of gastrointestinal tract and stomal leak were measured and detected.Results: After regional arterial perfusion thermochemotherapy with injection contained methylene blue by primary supply arterial, the tumor region colored immediately and then drop slowly. But the tumor region present blue during whole operation.After operation, Light microscope examination revealed a mild change of nuclear swelling and congulation of cytoplasm in cancer cells, mild hydropsia of intercellular substance, invasion of inflammatory cells and mild vasculitis in some of that cases. Transmission electron microscope found that nuclear swelling, nuclear heterochromatin agglutination,nuclear-week gap expansion, mitochondrial swelling,endoplasmic reticulum expansion,and Golgi complex expansion. AST of treated group increase in 1 day(P<0.01), and recover normal in 3 days(P>0.05). There is no marked difference on renal function, ALT, ALP, GGT, LDH, myelosuppression, ECG and reaction of gastrointestinal tract. And stomal leak was not found.Conclusion: The regional arterial perfusion chemotherapy during radical resection of gastric carcinoma enable gastric tumor to expose to chemotherapeutics during whole operation, present histopathological change of tumor and depress the activity of cancer cells.It is a safe and effective chemotherapeutics, can be used as an important supplementary means to prevent intra-operational extension and post-operative recurrence. But it only acts on patients of normal liver function, and protects liver after operation.