Apoptosis and histological response of preoperative intraarterial chemotherapy infusion for colorectal carcinoma

Objective: To investigate apoptosis and histological response of preoperative intraarterial chemotherapy infusion for colorectal carcinoma. Methods: Fifty patients with colorectal carcinoma were treated by intraarterial infusion of anti-cancer drugs. Surgical resection of the tumor was performed 5-30 days after the intraarterial infusion (mean 12 days). The histological response was evaluated. The density and distribution of the apoptosis cells were observed by DNA nick end labelling technique. 22 biopsy specimens before the intraarterial chemotherapy and 25 normal mucosa (obtained from surgery specimen) were used as controls. Results: The total histological response rate was 100% with grade I in 20 cases, grade II in 21 cases, and grade III in 9 cases. The density of the apoptosis cells was 31.47±5.58 before and 76.69±17.12 after the intraarterial chemotherapy infusion, and 8.01±3.39 in normal mucosa, respectively. The density of the apoptosis cells after the intraarterial chemotherapy was significantly higher than that before the intraarterial chemotherapy (t=13.701, P<0.001), while the density of the apoptosis cells in adenocarcinoma was significantly higher than that in normal mucosa (t=50,978, P<0.001). The 1-, 3-, and 5-year survival rate was 95.1%, 71.1%, and 48.5%, respectively. The histological response in different pathological stages was not significantly different (χ2=4.696, P>0.30). The apoptosis of adenocarcinoma was significantly different with different histological response (F=7.73, P<0.01). There were no significant differences in the apoptosis for different differentiated adenocarcinomas (t=0.3927, P>0.05) and for adenocarcinoma with different pathological stages (F=0.001376, P>0.05). Conclusion: As an effective and safe procedure, preoperative transcatheter intraarterial chemotherapy infusion achieves a significant histological response and apoptosis in colorectal adenocarcinoma