白芨应用于大鼠实验性肝细胞癌介入治疗的研究

Application of Bletilla striata in the interventional therapy of hepatocellular carcinoma: a comparative study in ACI rats

目的比较白芨和免疫反应调节剂、抗血管生成药物在介入经肝动脉化疗栓塞术(transarterialchemoembolization,TACE)治疗ACI大鼠肝细胞癌实验中的疗效。方法在70只♂ACI大鼠肝包膜下植入MorrisHepatom3924A肝癌瘤块(2mm3),移植术后13d进行磁共振(MRI)检查,测量肿瘤体积V1,第14天时,经腹部切开术及胃十二指肠动脉逆行插管至肝动脉而采取以下介入治疗方案(A)丝裂霉素+碘油+肿瘤坏死因子(TNFα)+白介素2(IL2)(n=10);(B)丝裂霉素+碘油+链球菌提取物(OK432)+IL2(n=10);(C)丝裂霉素+碘油+烟曲霉素(TNP470)(n=10);(D)丝裂霉素+碘油+血管内皮抑素+endostatin)(n=10);(E)丝裂霉素+碘油+白芨(n=10);(F)丝裂霉素+碘油+白芨+肝动脉结扎(n=10);(G)丝裂霉素+碘油(对照组,n=10)。13d后再次进行MRI检查以确定肿瘤体积V2变化,比较肝肿瘤体积生长率V2/V1。结果介入治疗后肿瘤体积与治疗前肿瘤体积之比(V2/V1)分别为A组7.30、B组6.53、C组4.01、D组7.78、E组6.28、F组1.53、G组9.14。与对照组相比,采取B、C、E、F组的治疗方案能有效抑制肝肿瘤的生长(P<0.05),而采取A、D组的治疗方案在肿瘤生长率方面与对照组差异无显著性(P>0.05)。其中,F组的疗效最佳且未见肝内肿瘤转移。结论白芨作为肝动脉栓塞剂并结合化疗药和肝动脉结扎?

OBJECTIVE To compare the effects of Bletilla striata and biological response modifier （BRM） /antiangiogenesis drug in the interventional therapy of hepatocellular carcinoma （HCC） in ACI rats. METHODS Subcapsular implantation of a solid Morris Hepatom 3924A （2 mm3 ） in the liver was carried out in 70 male ACI rats. Tumor volume （V1） was measured by magnetic resonance imaging （MRI） at day 13 after implantation. The following different agents of interventional treatment were injected after retrograde catheterization via gastroduodenal artery （day I4） namely： TACE （Transarterial chemoembolization,mitomycin ＋ lipiodol） ＋ Immunotherapy （group A： TNFa ＋ IL-2,group B： OK-432 ＋ IL-2）, TACE ＋ antiangiogenesis therapy （group C： TNP-470,group D： endostatin）, TACE ＋ Chinese medicinal therapy （group E： Bletilla striata ,group F：Bletilla striata .＋ ligation of hepatic artery） and TACE alone in group G （as control group）. Tumor volume （V2） was assessed by MRI （day 13 after treatment） and the mean tumor growth ratio （mean V2/V1） was calculated. RESULTS The mean ratio of V2/V1 were 7. 30 in group A,6. 53 in group B,4. 01 in group C,7. 78 in group D,6. 28 in group E, 1.53 in group F and 9. 14 in group G, respectively. Compared with the control group （group C） ,group B,C,E,F showed significant inhibition of tumor growth （P〈0. 05） ,while group A,D did not （P〉0. 05）. Group F obtained the best therapeutic effect in our experiments; also no development of intrahepatic metastases was detected in this group. CONCLUSION The combination of TACE and arterial administration of Bletilla striata plus ligation of hepatic artery is more effective than other therapeutic protocols in the treatment of HCC in rats.