肝癌射频消融与无水酒精消融的实验研究

An Experimental Study of radiofrequency ablation and ethanol injection on the Liver neoplasms

目的评价两种消融方法治疗兔VX-2肝癌的效果及副作用。方法30只荷瘤兔随机分3组,射频消融组(RFA);无水酒精组(PEI);生理盐水治疗组(NS)。术前、术后2周行MR扫描,比较肿瘤平均增长率;检测术前、术后肝肾功能指标;2周后取出肿瘤,比较坏死率,并行病理检查。结果3组两两间肿瘤平均增长率均有显著性差异(P<0.05),RFA组肿瘤平均增长率最小。各组间肿瘤坏死率也均有显著性差异(P<0.05),RFA组坏死率最大,达98.43±2.76%。除NS组外,其余两组肝肾功能指标术前、术后均有统计学差异(P<0.05),RFA组变化最明显。病理上,RFA组肿瘤呈重度坏死,有多核巨细胞反应,肉芽肿形成;PEI组呈轻-中度坏死,肝组织出现空泡变性(脂肪变性),部分血管有癌栓;各组胆管未受破坏。结论RFA的疗效较PEI明显;但对肝肾功能损害较PEI明显。临床上,应在兼顾肝肾功能情况下,选择适当的介入治疗方法。

Objective to evalute effects and side effects of radiofrequency ablation and ethanol injection on the rabbits bearing VX-2 hepatic tumor. Methods 30 rabbits with liver neoplasms were randomly divided into 3 groups. Radiofrequency ablation（RFA group）; Ethanol injection（ PEI group）; Normal saline （NS group）.MR1 scan were performed to examine the tumor size before and 2 weeks after treatment. The average growth rate of tumors were calculated to evaluate the therapeutic effectiveness.The changes of hepatic and nephric functions were detected in preoperative and postoperative. The necrotic rate of tumors were compared after killing the rabbits,and then the pathological examinations were performed. Results The average growth and necrotic rate of tumors were significant difference among 3 groups（P〈0.05）and the latter was highest in RFA group, 98.43±2.76%. The changes of hepatic and nephric functions were most manifest in RFA group. Pathologically ,tumor necrosis was severe in RFA group and there were multinucleated giant cell reaction and granuloma formation.It was Light - moderate necrosis in PEI group. Steatosis and tumor thrombus found in PEI group. Bile ducts unspoiled in each group.Conclusion The therapeutic efficacy of RFA was better than PEI, but for hepatic and nephric dysfunction than PEI obviously.Clinically, the selection of appropriate interventional treatment must base in hepatic and nephric functions.