化疗药在动脉化疗栓塞治疗大鼠肝癌实验中的价值

The Value of Chemotherapy Drug in Transarterial Chemoembolization Treating Hepatic Carcinoma of Experimental Rat

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。材料与方法 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)50μg+超液态碘油(UFLP)50μl+明胶海绵粉(GF)25 μg;B组 (常规剂量TACE,n=10)经肝动脉灌注5-FU 5 mg+MMC 50μg+UFLP 50μl+GF 25 μg;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 d,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组谷丙转氨酶(ALT)、谷草转 氨酶(AST)水平高于C组(P<0．05),而B组又高于A组(P<0．05),A、C组间总胆红素(1TBIL)与白蛋白(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。

Objective To evaluate the inhibiting effect of tumor growth and damage to liver by chemotherapy drug in transarterial chemoembolization （TACE） treating rat hepatic carcinoma. Materials and Methods Hepatic carcinoma models were made in Wistar rats, and then the following protocols of interventional therapy were carried out by TACE ： group A （low dosage group, n = 10） mitomycin50μg＋ ultrafluid lipiodol 50μl ＋ gelfoam spong powder25 ug; group B （conventional dosage group, n = 10） 5 - FU 5mg ＋ mitomycin 50μg ＋ ultrafluid lipiodol 50μl ＋ gelfoam spong powder 25μg; group C （general control group, n = 10） 0.9% NaCl 0.3 ml. TACE before and 12 days later, MRI were performed respectively to determine the tumor volume V1, V2 and V2/V1. All tumors tissue and pericancer liver tissues were performed with pathological examination. Liver function of every rat was assayed. Results In 27 survival rats, the values of V2/V1 were existed significant differences 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, characterized 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 that in 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 that in group B, ALB were higher than that in the group B （ P 〈 0.05）. Conclusion TACE with certain dosage chemotherapy drug can effectively treat implantation hepatic carcinoma of rat, increased dosage of chemotherapy drug cannot increase the therapeutic effect, on the other hand, enhance the damage to liver parenchyma and the influence on liver function.