目的:研究32P-磷酸铬(32P胶体)在肺癌手术中组织间照射对淋巴道隐匿性转移灶的治疗作用.方法:通过对73例肺癌患者采用手术切除肿瘤并配合32P胶体间质注射,并以同期同病种单纯手术治疗58例为对照,观察术后32P胶体在体表动态分布情况、并发症发生率、不同病理类型各组术后锁骨上淋巴结(SCL)转移率及1、3和5年生存率.结果:手术+32P胶体组及对照组均无手术死亡.两组淋巴结阳性率及术后主要并发症发生率均无显著性差异(X2=0.003～1.696,P>0.05).手术+32P胶体组术后锁骨上淋巴转移发生率明显低于单纯手术组(X2=4.507～5.348,P<0.05,P<0.01).手术+32P胶体组和单纯手术组1、3和5年生存率分别为82.2%、56.2%和38.7%、41.7%和25.5%.其中1年的生存率组间比较无显著性差异性(X2=0.659,P>0.05);3和5年组间生存率比较均有显著性差异(X2=4.207、3.997,P<0.05).结论:32P胶体在肺癌切除术中间质注射是一种安全、有效杀灭隐匿性转移灶以控制术后肿瘤局部复发和远处转移,并可以延长病患生存期的治疗方法.%Objective To study the effectiveness of interstitial irradiation by 32P-chromic phosphate (32P-colloid) on the latent metastasis during lung cancer resection. Methods 73 patients with lung cancer underwent resection of tumor and interstitial administration of 32 P-colloid, by the same time span, 58 patients with same diagnosis underwent operation served as control group. After operation the dynamic distribution of body surface 32P-colloid activity, incidence of complication, rates of supra-clavicle lymph node (SCL) metastasis in different pathologic patterns, and survival rates at 1-,3-,5- year were studied. Results No operative death occurred in these two groups. The pathologic patterns, incidences of lymph node metastasis and the incidences of major complication after operation were no significant differences between these two groups(?＝0.003-1.696,P>0.05). The incidence of post-operative SCL metastasis in surgery plus 32P-colloid group was significantly lower than that in surgery group(?＝4.507-5.348,P<0.05 or P<0.01).1-,3-,5- year survival rates of the former group were 82.2%,56.2% and 38.7%, those of the latter group were 77.6%,41.7%and 25.5%. In reviewing the 1-,3-,5-year survival rates in different pathologic pattern groups, there was no significant statistical difference between groups of the 1-year survival rates (?＝0.659,P>0.05), but the differences between the two groups of the 3-,5-year survival rates were significantly (?＝4.207,3.997,P＜0.05). Conclusion Interstitial injection of 32P-colloid during resection of lung cancer is a safe and effective procedure in controlling the latent lymphatic metastasis and local recurrence, and is surely to prolong the survival time of patients.
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