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目的探索、评价直肠癌术前辅助性治疗的新方法。方法直肠癌周粘膜多点连续封闭式注射抗癌药物５氟脲嘧啶（５ＦＵ），丝裂霉素Ｃ（ＭＭＣ）和卡铂（ＣＢＰ），次日手术。光学显微镜下观察原发灶和转移淋巴结内癌细胞变性、坏死程度，免疫组织化学染色检测肿瘤细胞增殖核抗原（ＰＣＮＡ）表达，并作为评判疗效的标准。结果直肠癌原发灶癌细胞变性５１例、坏死率８０％（４１／５１）；淋巴结转移灶变性坏死率为８２６％（１７１／２０７）；原发灶ＰＣＮＡ表达，治疗组阳性率７２％（３７／５１），对照组阳性率１００％（３０／３０），二者差异有显著意义（ｕ＝３１６，Ｐ＜００１）。平均ＰＣＮＡ指数（ＰＣＮＡＬＩ）分别为（４７±１９）％和（３８±１６）％，两者差异有显著意义（ｕ＝５４１，Ｐ＜００５）。淋巴结内癌细胞ＰＣＮＡ表达，治疗组阳性率７７３％，平均ＰＣＮＡＬＩ（４０±１３）％，对照组阳性率９１３％（１２６／１３８），平均指数为（５０±１９）％，两组差异有显著意义（Ｐ＜００５）。结论术前癌周粘膜下注射抗癌药物对原发灶和淋巴结内转移癌有杀伤作用并降低其增殖活性。重复给药可加强疗效，是一种安全有效的直肠癌辅助治疗方法。
Objective To explore and evaluate new methods for preoperative adjuvant treatment of rectal cancer. Methods Peritumal mucosa of multiple rectal cancers was continuously infused with 5 fluorouracil (5 FU), mitomycin C (MMC) and carboplatin (CBP), and the next day surgery. The degree of degeneration and necrosis of cancer cells in the primary tumor and metastatic lymph nodes were observed under an optical microscope. The expression of PCNA was detected by immunohistochemical staining and used as a criterion for judging the therapeutic effect. Results Degeneration of primary foci of rectal cancer was 51 cases, and the necrosis rate was 80% (41/51). The rate of necrosis of lymph node metastasis was 82.6% (171/207). The expression of PCNA in primary tumor was positive in the treatment group. % (37/51), the positive rate in the control group was 100% (30/30), and there was a significant difference between the two groups (u=316, P<001). The mean PCNA index (PCNALI) was (47±19)% and (38±16)%, respectively. There was a significant difference between the two (u=541, P<005). The expression of PCNA in lymph nodes was significantly higher in the treatment group (77. 3%) than in the control group (40±13)%. The positive rate in the control group was 91. 3% (126/138). The average index was (50±19)%. There was a significant difference between the groups (P<005). Conclusion Preoperative percutaneous submucosal injection of anticancer drugs has a killing effect on the primary tumor and metastatic lymph nodes and reduces its proliferative activity. Repeated administration can enhance curative effect and is a safe and effective method for adjuvant treatment of rectal cancer.