目的:了解进展期胃癌术中组织间注射靶向化疗(IICT)对转移淋巴结Ki-67表达和细胞凋亡的影响.方法:将满足要求的28例进展期胃癌病例随机分成治疗组和对照组.治疗组先于肿瘤组织及周围注射亚甲蓝和丝裂霉素的混合液后再手术,对照组直接手术.观察两组病例转移淋巴结的肿瘤坏死变性有效性、Ki-67表达和细胞凋亡情况.结果:治疗组转移淋巴结的肿瘤细胞变性坏死有效率高于对照组,差异有统计学意义(P＜0.05);治疗组治疗后转移淋巴结Ki-67表达阳性率低于治疗前,肿瘤细胞凋亡指数高于治疗前,差异均有统计学意义(P＜0.05);治疗组治疗后转移淋巴结的Ki-67表达低于对照组,肿瘤细胞凋亡指数高于对照组,差异有统计学意义(P＜0.05).结论:IICT能够抑制胃癌转移淋巴结内肿瘤细胞增殖,促进肿瘤细胞凋亡,对防止医源性扩散、微转移、微残留和术后复发、转移可能有一定作用.%Objective： To investigate the effect of intraoperative interorganizational injection chemotherapy targed (IICT) on ki-67 and apoptosis in metastatic lymph nodes of advanced gastric carcinoma. Methods: 28 patients with the condition who were randomly divided into two groups (treatment group arid control group), for the treatment group a mixture of methylene blue and mito-mycin (MMC) was injected in the tumor tissue or its surrounding before the operation, the direct surgery for control group.After the operation, The specimens (including the radical former specimens) were observed the effectiveness and detected ki-67 expression .cell apoptosis. Resultes:After IICT, the effectiveness (rate) of tumor cell degeneration and necrosis for treat group is higher than those in the control group, the two groups was statistically significant difference (P<0.05).The Ki-67 positive expression rate in metastatic lymph nodes of the treatment group is lower and tumor cell apoptotic index is higher than those before the treatment, statistically significant difference between before and after (P<0.05).The Ki-67 expression in metastatic lymph nodes of the treatment is lower and tumor cell apoptosis index is higher than those in the control group, the two groups was statistically significant difference (P<0.05) Conclusions IICT can inhibit tumor cell proliferation, promot tumor cell apoptosis and has a direct therapy for metastatic lymph nodes of advance gastric cancer. It may have a role to prevent the iatrogenic spread and recurrence .metastasis after the surgery.
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