【作者】 杨奎； 尹君； 钱骏； 靳雪广； 罗军； 黄乐秀； 刘仔杰； 梁泳；

【机构】 河南省信阳市中心医院介入放射科； 华中科技大学同济医学院附属协和医院介入放射科；

【摘要】 目的评价经肝动脉化疗栓塞术(transarterial chemoembolization。TACE)治疗大鼠移植性肝癌中化疗药物的抑瘤及肝损害作用。材料和方法复制大鼠移植性肝癌模型,经肝动脉插管采取以下介入治疗方案:A 组(小剂量 TACE,n=10):经肝动脉灌注丝裂霉素(MMC)50ug+超液态碘油(UFLP)50ul+明胶海绵粉(GF)25ug;B 组(常规剂量 TACE,n=10)经肝动脉灌注5-FU 5mg+MMC 50ug+UFLP 50ul+ GF 25ug;C 组(对照组,n=10)经肝动脉灌注生理盐水0.3 ml。介入术前及术后12天,分别行 MRI 检查测量肿瘤体积 V1及 V2,并计算、比较 V2/V1,取术后肿瘤及瘤周肝组织行病理学检查,并行肝功能检查。结果存活27只大鼠,V2/V1比较结果:C 组高于 A、B 组,且均有显著性差异(P<0.05),而 A、B 两组无显著性差异(P>0.05);三组间肿瘤坏死程度分别为58.25%、55.60%、26.67%,C 组低于 A、B 组。均存在显著性差异(P<0.05),而 A、B 两组无显著性差异(P>0.05);三组间瘤周肝组织改变分别为肝细胞胞浆疏松化、气球样变、无变性坏死;肝功能比较结果:A 组 ALT、AST 水平高于 C 组(P<0.05),而 B 组又高于 A 组(P <0.05),A、C 组间 TBIL 与 ALB 水平无显著性差异(P>0.05),但前者低于 B 组(P<0.05)后者高于 B 组(P<0. 05)。结论:一定剂量化疗药的 TACE 可有效治疗大鼠移植性肝肿瘤,增加化疗药剂量并不能增加这种作用. 相反能明显加重对肝组织的损害及对肝功能的影响作用。更多还原

【Abstract】 Objective To evaluate the inhibiting effect of tumor growth and damage to liver of anticancer drug in transarterial chemoembolization (TACE) treating rat hepatic carcinoma.Methods Construct hepatic carcinoma model in Wistar rats,and then the following protocols of interventional therapy were carried out by TACE:group A (low dosage group,n=10) mitomycin50 ug+ ultrafluid lipiodol 50 ul+ gelfoam spong powder25 ug;group B (conventional dosage group,n=10) 5-FU 5mg+mitomycin50 ug+ultrafluidl50 ul+gelfoam spong powder25 ug;group C (general control group,n=10)0.9%NaCl 0.3 ml.Before TACE and 12 days later,MRI were performed respectively to determine the tumor volume V1,V2 and V2/V1.All tumors tissue and paracancer liver tissues were performed pathological examination.Liver function of every rat was assayed.Results In 27 survival rats,the values of V2/V1 were 697.80%±96.57%,633.38%±92.27%,1300.11%±167. 60%,in group A,B,C respectively,significant differences existed between group A and C,B and C (P<0.05),not between A and B;the extent of necrosis of tumors were 58.25%,55.60%,26.67%,in group A,B,C respectively,significant differences were observed between the group A and C,B and C(P<0.05),not between A and B(P>0.05);Hydropic degeneration was showed in the group A and B,charactered by loose shape and balloon shape respectively,not in group C;The values of ALT and AST in group B were higher than those in the group A and C(P<0.05),also these higher in the group B than the group C(P<0.05);significant differences were not found in the values of TBIL and ALB between the group A and C(P>0.05),but TBIL in the two group lower than,ALB higher than that in the group B (P<0.05).Conclusions TACE containing certain dosage anticancer drug can effectively treat implantation hepatic carcinoma of rat,increased dosage of anticancer drug cannot increase the therapeutic effect,on the other hand,augment the damage to liver parenchyma and the influence on liver function.更多还原