Kojima S
Department of Surgery, Sendai National Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1989 May;90(5):686-94.
This study was undertaken to evaluate the effectiveness of perioperative adjuvant chemotherapy for the treatment and prevention of lymph node metastasis of colorectal cancer. Namely, ten thousand unit (U) of NCS, the high molecular weight anti-tumor agent, was injected into the subserosa of the colon (n = 51), the tumor-feeding arteries (n = 6), or the peripheral veins (n = 6) immediately after laparotomy, and tissue concentration of NCS in the regional lymph nodes and intestinal wall was measured. After the injection of NCS into the subserosa, the regional lymph nodes showed higher concentration of 4.55-6.34U/g regardless of metastasis. Concentrations in the lymph nodes after NCS into the tumor-feeding arteries showed similar high level as those after the subserosal injection in Group 1 lymph nodes (paracolic and epicolic nodes), but not in Group 2 lymph nodes (intermediate nodes). The injection of NCS into the peripheral veins demonstrated a wide range of 0.01-5.0U/g, half of them being not effective concentrations. Perioperative injection of NCS into the subserosa in the colorectal cancer was technically simple and safe and a large amount of the agent was taken into the regional lymph nodes. Therefore, this strategy may be a rational treatment for slight or jumping metastases in the lymph nodes.
本研究旨在评估围手术期辅助化疗对结直肠癌治疗及预防淋巴结转移的有效性。具体而言，在剖腹手术后立即将10000单位（U）的高分子量抗肿瘤剂NCS注入结肠浆膜下（n = 51）、肿瘤供血动脉（n = 6）或外周静脉（n = 6），并测量区域淋巴结和肠壁中NCS的组织浓度。将NCS注入浆膜下后，无论有无转移，区域淋巴结均显示出较高浓度，为4.55 - 6.34U/g。将NCS注入肿瘤供血动脉后，第1组淋巴结（结肠旁和结肠上淋巴结）中的淋巴结浓度与浆膜下注射后的浓度相似，但第2组淋巴结（中间淋巴结）并非如此。将NCS注入外周静脉后的浓度范围为0.01 - 5.0U/g，其中一半为无效浓度。在结直肠癌中，围手术期将NCS注入浆膜下技术简单且安全，大量药物进入区域淋巴结。因此，该策略可能是治疗淋巴结微小或跳跃转移的合理方法。
