活性炭-表阿霉素混悬液对乳腺癌腋窝淋巴结转移的治疗作用

目的评价活性炭微粒-表阿霉素(Epi-CH)混悬液对乳腺癌腋窝淋巴结清扫和转移灶化疗的改进作用。方法60例II-III期乳腺癌病人随机分为两组,治疗组40例术前72h于瘤床或肿瘤周围腺体注射Epi-CH混悬液10mg,对照组20例注射表阿霉素水溶液10mg,术后清点腋窝淋巴结总数和黑染淋巴结数并计算腋窝淋巴结清除率。用高效液相色谱法检测治疗组黑染和未黑染淋巴结中表阿霉素的含量。光镜观察淋巴结组织变性坏死改变。结果治疗组平均每例清除淋巴结比对照组多4.04个(P<0.01)。治疗组中腋窝淋巴结的黑染率为86.9%(565/650);直径≤1.0cm淋巴结黑染率明显高于直径﹥1.0cm淋巴结黑染率(P<0.01);黑染淋巴结癌转移率与未黑染淋巴结转移率无显著性差异(P>0.05)。治疗组黑染淋巴结中表阿霉素的含量是未黑染淋巴结含量的14.3倍(P<0.01)。黑染淋巴结内癌细胞有明显的变性坏死改变。结论Epi-CH混悬液能增加手术清除的腋淋巴结数目,显著增加并维持表阿霉素在局部淋巴结中的高浓度。

Efficacy of activated charcoal-epirubicin suspension for treatment of breast cancer with axillary metastasis

OBJECTIVE: To investigate the effect of activated charcoal-epirubicin suspension (Epi-CH) for treatment of breast cancer and clearance of axillary lymph node metastasis. METHODS: Sixty patients with breast cancer of stages II-III were randomized into Epi-CH group (n=40) receiving injection with 10 mg Epi-CH in the tissue around the primary tumor 72 h before modified radical resection and control group (n=20) with 10 mg of aqueous epirubicin injection in the same region. The dissected axillary lymph nodes and the staining lymph nodes were counted. The concentration of epirubicin in the lymph nodes was detected by high-performance liquid chorography, and the specimens of lymph nodes were observed microscopically. RESULTS: In comparison with the control group, Epi-CH injection allowed dissection of 4.04 more lymph nodes (P<0.01) and resulted in the staining rate of the axillary lymph nodes of 86.9% (565/650). The proportion of the staining lymph nodes with diameter>1.0 cm was significantly lower than that with diameter 0.05). In Epi-CH group, the concentration of epirubicin in the stained lymph nodes was significantly higher than that in non-stained ones (443.0-/+123.1 vs 31.8-/+11.9 ng/g, P<0.01). Remarkable degeneration and necrosis could be observed microscopically in the stained lymph nodes. CONCLUSION: Epi-CH allows more effective treatment of breast cancer and clearance of axiliary metastasis by increasing the dissected lymph nodes and raising the concentration of epirubicin in the axillary lymph nodes.