Research Of Pirarubicin On Inducing The Apoptosis Of Breast Cancer Cells--The Exfoliative Cancer Cell Examination Of The Washing Liquid And The Clinical Significant Of Washing The Surgical Field With Pirarubicin In The Patients Of Breast Cancer

Objective:Recent years,the intraoperative chemotherapy has been used in the patients with breast cancer and proved effective. This experiment was designed to study the prevention effects of intraoperative hot hypotonic solution soaking chemotherapy on cancer recurrence after resection of breast cancer by washing the operational field with Pirarubicin and examining the exfoliative cancer cellMethods:59 cases with breast cancer of China-Japan Union Hosptal (2008-06~2009-01) treated by operation were randomly divided into study group(n=31) and control group (n=28). Before the operative wound closing, the wound of both groups were washed with normal saline solutions(200ml) first and the washing solutions were collected for examination of exfoliative cancer cell, then the operative wounds of study group were treated with Pirarubicin(20mg:200ml distilled water), while the wounds of control group were washed with normal saline solutions (200ml) only. After that the wounds of both groups were washed with normal saline solutions(200ml) and the washing solutions were collected for examination of exfoliative cancer cell. The rates of exfoliative cancer cell in operative fields and the postoperative locally recurrence rates of breast cancer in the two groups were compared.Results:1.The rates of exfoliative cancer cell after the first NS washing in study group and of control group were 29.03% and 28.57% respectively (P>0.05). The total rates of exfoliative cancer cell was 28.82%. The positive rate of exfoliative cancer cell has significant relationship with the size of tumor, clinical stages, metastases of axillary lymph nodes , but no relationship with ER and the type of operation. 2.The positive rate of exfoliative cancer cell after intraoperative chemotherapy was 3.22% in study group; after second NS washing, the positive rate of exfoliative cancer cell was 17.86% in control group. The difference between the two groups was statistically significant (P<0.05). 3. The days of wound healing, the rate of after-operational complications between the two groups was not significantly different (P<0.05).4.The localy recurrent rates were 0% in sutdy group and 3.57% in control group until now. The localy recurrent rate of study group was significantly lower than that of control group.Conclusion:1. There were positive exfoliative cancer cells in the surgical field. The positive rate of exfoliative cancer cell of the washing liquid can measure the effects of the intraoperative chemotherapy. 2. The positive rate of exfoliative cancer cell has significant relationship with the size of tumor., clinicals stages,metastases of axillary lymph nodes ,no relationship with ER and the type of operation. 3. Pirarubicin is effective by washing the operational wound of the patients with breast cancer.It can reduce the rate of local recurrence, but no more complications.4.We should pay much attention to the iatrogenic dissem- ination.5.This experiment limited by few cases and needs more provements in evidence-based medicine.6. The intra-operation chemotherapy were necessary in operation ,the treatment is reasonable,the local recurrence is reduced.But we are still required to focus on the concentration and dose of the drug.