氩氦刀冷冻消融和射频、微波热凝固治疗兔VX_2肝癌的对比研究

Therapeutic effects of cryoablation, radiorequency ablation, and microwave coagulation against VX2 liver cancera comparative study in rabbits

目的通过观察肿瘤残留和转移情况、治疗前后免疫功能变化以及兔的生存期并加以对比,探讨氩氦刀冷冻、射频消融(RFA)及微波凝固(MCT)治疗兔VX2肝癌的疗效。方法将45只兔VX2肝癌模型随机分为五组,每组9只,即氩氦刀冷冻组(A组)、射频消融组(B组)、微波凝固组(C组)、手术切除组(D组)和对照组(E组)。观察肿瘤转移情况(肝内转移、肺部转移、腹腔淋巴结转移和腹腔种植转移)和可溶性白介素-2受体(sIL-2R)变化及生存期等。结果①肝内肿瘤残留在A、B、C、D、E组分别为2、4、5、0、9只,差异有显著性(χ2=20.700,P=0.000);肝内转移分别为1、3、4、6、9只,差异有显著性(χ2=15.652,P=0.004);腹腔种植转移率分别为2、5、6、0、1只,差异有显著性(χ2=13.894,P=0.008);肺部及腹腔淋巴结转移各组均为9只,差异无显著性。②各组治疗前sIL-2R无明显差异,治疗后各组间差异有显著性(F=31.58,P=0.000);各组内治疗前后比较,A组、B组、C组和D组差异均无统计学意义,E组差异有显著性(t=10.119,P=0.000)。③平均生存期:氩氦刀冷冻、RFA、MCT和手术切除组与对照组比较有显著性差异(F=73.084,P=0.000);氩氦刀冷冻和手术切除组显著高于RFA、MCT组;氩氦刀冷冻和手术切除组之间、RFA和MCT组之间无显著性差异。结论在治疗兔VX2肝癌中,无论是在减少肿瘤残留和转移方面,还是在增强机体免疫力方面及延长实验兔生存期方面,氩氦刀冷冻治疗均优于RFA和MCT;而RFA和MCT疗效相当。

Objective To Compare the therapeutic effects of cryocareTM cryoablation, radiofrequency ablation（RFA）, and and microwave coagulation （MCT） in rabbits with VX2 liver cancer. Methods Forty-five rabbits with VX2 liver cancer were randomly and equally allocated into 5 groups to receive treatment with cryocare cryoablation （group A）, radiofrequency ablation （group B）, microwave coagulation （group C）, surgical resection （group D） and control group （group E）, respectively. The residual tumor tissues and metastasis （intrahepatic, lung, abdominal lymphoid node, and abdominal implantation） were observed after the treatments, with also detection of soluble interleukin-2 receptor （sIL-2R） and recording of the survival time of the rabbits. Results Significant differences were found in the occurrence of tumor residue （X^2=-20.700, P=0.0000）, intrahepatic metastasis （X^2=-15.652, P=0.0004）, and abdominal implantation tumor （X^2=-13.894, P=0.0008） between the 5 groups, but not in lung and abdominal lymph node metastasis, sIL-2R levels differed significantly only after but not before the treatments （F=31.58, P= 0.000） between groups A to D and group E （t=10.119, P=0.000）. The treatments in groups A to D all resulted in prolonged survival of the rabbits as compared with the control （F=73.084, P=0.000）, and cryocareTM cryoablation and surgical resection showed similarly better effect than RFA and MCT. Conclusion Cryocare cryoablation can be more effective than RFA and MCT in reducing minor residue and metastasis and prolonging the survival time of rabbits with VX： liver cancer, and RFA and MCT are comparable for their therapeutic effects.