The Study Of The Chemotherapeutic Effect Of Epi-CH Suspension On The Axillary Metastasis Lymph Nodes In Patients With Breast Cancer

Objectives To investigate the chemotherapeutic effect of charcoal activated absorbing epirubicin suspension (Epi-CH) on the axillary metastasis lymph nodes in patients with breast cancer.Methods 60 patients with breast cancer were divided into two groups randomly. 40 patients (Epi-CH group) were injected Epi-CH 10mg into the region around the tumor or biopsy excision. 20 patients (control group) were injected epirubicin lOmg into the same region. After 48-72 hours, the modified radical mastectomy was operated. The axillary lymph nodes and the staining lymph nodes were calculated. The concentration of epiribicin in lymph nodes was measured by high performance liquid chorography (HPLC). The apoptosis index (AI) was detected by terminal deoxynucleotidy trans ferase mediated digoxigenin-dUTP nick end labeling (Tunel). The proliferation index (PI) and the expressions of apoptosis related gene proteins(including bcl-2, bax, C-myc, Fas, Fas-L) were detected by S-P. Statistical analysis was performed using SPSS 10.0. Results The average number of dissected lymph nodes in Epi-CH group was 15.20\1.22, and that in control group was 11.10\1.43, The average number ofdissected lymph nodes in Epi-CH group was markedly higher (p < 0.01) .In Epi-CH group, the staining rate of axillary lymph nodes was 88.8% (577/650). The metastasis rate of staining lymph nodes (219/577) was significantly higher than that of non-staining lymph nodes (18/73) (p < 0.05). The proportion of the staining lymph nodes with diameter > 1.0cm(102/131) was lower than that with diameter ≤ 1.0cm (475/519). In Epi-CH group, The concentration of epirubicin in staining lymph nodes (443.0 ± 123.1ng/g) was higher significantly than that of non-blackened (31.8±11.9ng/g) (p < 0.01). AI of blackened lymph nodes in Epi-CH group (9.5% ±2.1%) was increased remarkable than that in control(3.8% ±1.4%) (p < 0.01). PI of blackened lymph nodes in Epi-CH group (60.1 % ± 12.1 %) was decreased significantly than that in control group(73.5%±12.4%) (p < 0.05). The expressions of bcl-2, bax, Fas-L gene protein in Epi-CH group were up-regulated(p < 0.05), but those of C-myc and Fas was not different between two groups (p > 0.05).Conclusions The study indicates that lymphatic chemotherapy using Epi-CH can increase the dissected lymph nodes during modified mastectomy, rise the concentration of epirubicin in axillary lymph nodes, enhance the cancer cell apoptosis and reduce the cancer cell proliferation. The lymphatic chemotherapy effects of Epi-CH result from up-regulation of expressions of bax and Fas-L geneproteins.