RFA联合TACE和HFH对兔肝VX2肿瘤的作用

The effect of radiofrequency ablation combined with transcatheter arterial chemoembolization and high frequency hyperthermia on rabbit liver VX2 carcinoma

目的探讨射频消融(RFA)联合高频热疗(HFH),经动脉化疗栓塞(TACE)治疗兔肝VX2肿瘤的作用。方法将兔肝VX2肿瘤模型分为:RFA+TACE+HFH治疗组(A组),RFA+HFH治疗组(B组),RFA+TACE治疗组(C组)和TACE+HFH治疗组(D组)。观察各组治疗前后的血清谷丙酸转氨酶(ALT),肝脏热休克蛋白(HSP70)及脾脏树突状细胞(DCs)表达。结果(1)ALT:在治疗组第1天均明显升高,A组升高幅度最大,14 d内恢复最慢;B组上升幅度最小,恢复最快(P<0.05)。(2)HSP70表达:A组治疗后明显上升,14 d时仍为最高;D组上升幅度最小,14 d时表达值最低(P<0.05)。(3)DCs表达:A,B组无明显差异(P>0.05),并且组内14 d和7 d时两者差异无显著性。C,D组明显低于其余两组,且下降较快(P<0.05)。结论RFA+TACE+HFH能更好地激活HSP70和树突状细胞的表达,增加机体抗肿瘤免疫的能力,但同时损害肝功能最明显。联合运用时须综合考虑。

Objective To evaluate tbe effect of radiofrequency ablation （ RFA ） comblined witb bigh frequency hyperthermia （HFH） and transcatbeter arterial cbemoembolization （TACE） on rabbit liver VX2 tumor. Methods Rabbit liver VX2 tumor models were divied into the following group ： Group A, RFA ＋ TACE ＋ HFH ; Group B, RFA ＋ HFH ; Group C, FA ＋ TACE ; Group D, TACE ＋ HFH. The changes of ALT, hot shock protein 70 （ HSP 70 ） expression of liver and dendritic cells （ DCs ） expression of spleen before and after therapy were observed. Results （ 1 ） ALT： value of ALT was markedly elevated on 1 d after therapy in all groups, but was greatest in Group A and also was the slowest to recover at 14 d ; the degree of elevation was least in Group B and was the fastest to recover （ P 〈 0.05 ）. （ 2 ） HSP70 expression： It was markedly elevated in Group A and was still the highest at 14 d; the degree of elevation was least in Group D and was the lowest at 14 d （P 〈 0.05 ）. （3）. DCs expression： There was no difference between Groups A and B at 14 d and 7 d （P 〉0. 05）; and Groups C and D were markedly lower than the A and B group, and declined more quickly （ P 〈 0. 05 ）. Conclusions RFA ＋ TACE ＋ HFH can effectively activate the expression of Hsp70 and DCs, and enhance antitumorimmunopotency of the organism, but, at the same time, can most markedly damage liver function. Therefore, their combined use should be given an all-round consideration.