p53抑癌基因(今又生)应用于恶性间皮瘤、消化道肿瘤所致的恶性浆膜腔积液的控制,观察其对恶性积液的治疗效果。选择经病理组织学或细胞学确诊或影像学结合肿瘤标记物血清学检查临床诊断的恶性间皮瘤、食管癌、胃癌、胰腺癌和结肠癌等消化道肿瘤伴发恶性浆膜腔积液的患者32例,治疗前后客观测量积液量,用100mL生理盐水溶解p53抑癌基因(今又生)1支(1×1012VP),注入浆膜腔,72h后体外射频热疗,每周1次,治疗2周后评价积液控制效果。结果8例恶性间皮瘤CR2例,PR3例,NE3例,临床有效率为62%;24例恶性消化道肿瘤CR5例(其中食管癌1例,胃癌3例,结肠癌1例),PR7例(其中食管癌1例,胃癌4例,结肠癌2例),NE12例,临床有效率为50%。初步研究结果提示,p53抑癌基因——今又生可用于治疗恶性间皮瘤、消化道肿瘤(食管癌、胃癌、结肠癌)伴发的恶性浆膜腔积液,积液控制效果明显。 【关键词】：基因,p53;间皮瘤;肿瘤/治疗 “今又生”(Gendicine)是一种广谱的肿瘤基因治疗制品。目前,在临床上使用“今又生”已治疗了头颈部肿瘤等多种不同的肿瘤。“今又生”基因治疗药由载体DNA和基因两部分组成。“今又生”的抑癌基因是p53基因,载体则是源于腺病毒DNA。p53基因是抑癌基因,而源于腺病毒DNA,可以有 The objective of this stud was to investigate the efficacy and toxicity of p53 gene Gendicine in the treatment of malignant effusions caused by malignant mesothelioma and alimentary tract carcinoma. The patients with malignant mesothelioma and alimentary tract carcinoma(including esophageal carcinoma,gastric cancer,pancreatic cancer,colon cancer), diagnosed by pathological evidences or image and serum tumor markers, following malignant effusions, were treated by p53 gene transfer of Gendicine peritoneal perfusion in 100 mL normal saline.After 72 h,the patients received radiofrequency hyperthermia.The treatment was performed 1 cycle per week.The volume of effusions were examined at the begining and 2 week later. There were 2 cases of complete response(CR), 3 cases of partial response(PR), and 3 cases no effect(NE)in 8 cases of malignant mesothelioma. The clinical profit rate was 62%. There were 5 cases of CR(1 case of esophageal carcinoma, 2 cases of gastric cancer,1case of colon cancer),7 cases of PR(1 case of esophageal carcinoma, 4 cases of gastric cancer,2 cases of colon cancer),and 12 cases of NE in 24 cases of malignant alimentary tract cancer. The clinical profit rate was 50%. Conclusion: p53 gene Gendicine can treat malignant effusions caused by malignant mesothelioma and alimentary tract cancer (esophageal carcinoma, gastric cancer, colon cancer), and its curative effect is defined. 【Keyword】：gene, p53;gendicine;mesothelioma;neoplasms/therapy