Murakami N, Hirano M, Saito H, Nagao S, Arano Y, Kikuchi T, Ishikawa N, Kurokawa M, Kitsukawa H
Dept. of Surgery, Kohseiren Takaoka Hospital.
Gan To Kagaku Ryoho. 1996 Dec;23(14):1959-66.
We administered preoperatively 5'-deoxy-5-fluorouridine (5'-DFUR) for treatment of advanced gastric and colonic cancers, and measured pyrimidine nucleoside phosphorylase (PyNPase) in the excised tumor sample and serum immunosuppressive acidic protein (serum IAP), which is an index of the immunity of host-bearing cancer, while studying its direct antitumor effect and improved immunity. Patients with 24 advanced gastric cancers and 36 colonic cancers were randomly divided into a preoperatively administered group and a non-administered group. In the preoperatively administered group, 5'-DFUR (1,200 mg/day) was orally administered on preoperative days 7 approximately 14. After collecting samples (about 0.5 g) from adjacent normal tissues with tumor within 30 minutes after extirpation of tumor and freezing those less than -20 degrees C, the PyNPase level was measured as soon as possible. Moreever, serum IAP levels at pre-administration in the administered group and on admission in the non-administered group were measured. Those in the administered group were measured again on the operative day. No decreasing tendency of PyNPase was generally found in cases with gastric colonic cancers, and no significant difference in stage-II was not either. However, a decreasing tendency in tumor activity was found by pre-administration. Moreover, there was significant improvement in the serum IAP level in cases with gastric and colonic cancers by pre-operative administration of 5'-DFUR. This tendency was also found in advanced colonic cancer with Dukes-C by Dukes's classification. In conclusion, it was suggested that the pre-operative administration of 5'-DFUR for treatment of advanced gastric and colonic cancers has a favorable influence for prognosis because the tumor region was retarded by the high PyNPase activity according to the severity of tumors and elevating tendency of the immune response in host.
我们术前给予5'-脱氧-5-氟尿苷(5'-DFUR)治疗晚期胃癌和结肠癌,并在切除的肿瘤样本中测量嘧啶核苷磷酸化酶(PyNPase)以及血清免疫抑制酸性蛋白(血清IAP,它是荷癌宿主免疫的一个指标),同时研究其直接抗肿瘤作用和免疫改善情况。24例晚期胃癌患者和36例结肠癌患者被随机分为术前给药组和未给药组。在术前给药组中,于术前第7天至大约第14天口服5'-DFUR(1200毫克/天)。在肿瘤切除后30分钟内从肿瘤周围的正常组织采集样本(约0.5克),并在低于-20摄氏度的条件下冷冻,然后尽快测量PyNPase水平。此外,测量给药组给药前以及未给药组入院时的血清IAP水平。给药组患者在手术当天再次测量。胃癌和结肠癌患者中一般未发现PyNPase有下降趋势,II期患者也无显著差异。然而,术前给药发现肿瘤活性有下降趋势。此外,术前给予5'-DFUR可使胃癌和结肠癌患者的血清IAP水平有显著改善。根据Dukes分类法,在Dukes-C期的晚期结肠癌中也发现了这种趋势。总之,提示术前给予5'-DFUR治疗晚期胃癌和结肠癌对预后有良好影响,因为根据肿瘤的严重程度,高PyNPase活性可使肿瘤区域生长迟缓,且宿主的免疫反应有升高趋势。