不同浓度乙醇消融VX2兔移植性肝肿瘤的实验研究

Experimental research of percutaneous ethanol therapy with different concentration injections on hepatic vx2 tumor of rabbits

目的探讨不同浓度乙醇经皮瘤内注射(PEI)疗法对兔移植型肝癌的治疗效果。方法31只新西兰兔肝内植入VX2瘤块(1 mm3),移植后14 d行CT扫描,测量肿瘤体积。然后采取以下治疗:A组经皮瘤内注射无水乙醇(9只)、B组注射75%乙醇(9只)、C组注射50%乙醇(9只)、D组未予任何处理(对照组,4只)。治疗后7、14、21 d分别行CT、MRI扫描,观察病灶的变化并测量大小,每组处死2只取病理观察肿瘤大小、光镜下观察肿瘤的凝固性坏死与对照组比较,治疗后60d内观察各组生存期的长短。结果PEI治疗前和治疗后21 d肿瘤体积之比分别为:A组1.68、B组1.75、C组5.81、D组8.72。与对照组相比,C组抑制肿瘤生长的无显著性差异(P>0.05),A、B组均能抑制肿瘤的生长(P<0.01,P<0.01),且A组与B组抑制肿瘤生长的无显著性差异(P>0.05)。平均生存时间为:A组(53.7±6.3)d,B组(52.8±7.4)d,C组(46.3±5.2)d,D组(34.1±3.7)d。治疗组病理切片光镜下肿瘤凝固性坏死范围随乙醇浓度的增加而增大。结论PEI可抑制肿瘤的生长,延长荷瘤兔的生存期,且随着乙醇浓度的升高生存期延长,75%以上浓度乙醇治疗效果的差异无统计学意义,但高浓度(≥75%)乙醇比低浓度(<75%)乙醇能明显抑制肿瘤的生长,延长生存期。

Objective To compare the therapeutic efficacies of percutaneos intratumoural injection of ethanol with different concentrations （PEI） in rabbits bearing liver tumors. Methods Implantation of a solid VX2 tumor （1 mm^3） in the liver was carried out in thirty-one Newland rabbits. Tumor volume was measured by CT scanning at 14th day after implantation. The following different agents were percutaneously injected, namely： （A） received anhydrous ethanol（ n = 9）, （ B ） received 75% ethanol（ n = 9）, （C） received 50% ethanol（ n = 9） and group （D） （control） received nothing（n = 4）. Tumor sizes and changes were observed by liver CT ,MRI enhanced imaging at 7,14and 21 days after injection, and pathology was also obtained of tumor size and coagulation necrosis through killing two rabbits in each group. Survival time was calculated from the day of treatment up to two months. Results The volume mean ratios before PEI and 21 days after PEI was 1.53 in group A, 1.75 in group B, 5.81 in group C, 8.72 in group D. Comparing with the control group （group D）,group C showed no significant inhibition of tumor growth （ P 〉 0.05, ）, and same as in group A and group B. The mean survival times were （53.7± 6.3） d in groupA, （52.8±7.4） d in group B, （46.3±5.2） d in group C and （34.1±3.7） d in group D, respectively. Coagulation necrosis area of PEI in each group increased propostionately with ethanol concentration. Conclusions The growth of rabbit＇ s liver tumor can be inhibited by PEI, and the survival time is proportionately longer with ethanol concentration, although there is no statistical significance in higher than 75% concentration ethanol.