重组人血管内皮抑制素动脉内灌注及栓塞治疗兔VX2肝癌的安全性及有效性

Safety and efficacy of recombinant human endostatin plus TACE on treating rabbits bearing VX2 liver tumor

目的评估经肝动脉灌注重组人血管内皮抑制素(rh-endostatain)联合TACE治疗兔VX2肝癌的安全性及有效性。方法30只VX2肝癌兔随机分为3组,每组10只。A组:肝动脉灌注rh-endostatin+TACE;B组:单纯TACE;C组:对照组。3组兔均于术前1天及术后3天、7天、14天分别抽血作肝肾功能检查,获取ALb、ALT、AST、BUN、Cr指标;并于术前1天、术后2周分别行CT扫描,测量肿瘤最长径。扫描后立即处死动物,组织切片用于免疫组化检测MVD、VEGF表达。结果术后A、B、C组兔肝功能指标与术前比较差异有统计学意义(P<0.05),且术后A、B组肝功能指标与C组比较差异有统计学意义(P<0.01);A、B两组间各时间段肝功能指标差异无统计学意义(P>0.05)。3组兔BUN、Cr治疗前后差异无统计学意义(P>0.05)。治疗后2周,A、B两组肝癌最长径均明显低于C组(P<0.01)。A组MVD、VEGF较B、C两组明显减低(P<0.01)。结论肝动脉灌注rh-endostatain不会引起肝、肾功能毒性,且其联合TACE治疗肝癌能减慢肿瘤的生长速度,抑制TACE后肿瘤新生血管的形成。

Objective To evaluate the safety and efficacy of recombinant human endostatin（rh-endostatain）arterially administrated with TACE on VX2 liver tumor.Methods Thirty rabbits bearing VX2 liver tumor were randomly devided into 3 groups：group A：rh-endostatain arterially administrated with TACE;group B：single TACE;group C（control group）：saline injection alone.The liver and renal function of all rabbits was examined 1 day before treatment and 3,7,14 days after treatment.Routine CT scan was performed 1 day before treatment and 2 weeks after therapy with largest dimension（LD）measurement of the tumor.Immunohistochemical biomarkers of MVD and VEGF expression of tumor were examined.Results The level of ALb,ALT,AST before and after therapy was singnificantly different in all three groups（P〈0.05）.The level of ALb,ALT and AST after thearapy in group A and B were singnificantly different from that in group C（P〈0.01）,but not singnificantly different between group A and B（P〉0.05）.There was no difference in BUN and Cr among all three groups（P〉0.05）.The LD of the tumor at 2 weeks after treatment were significantly lower in group A and B than that in control group（P〈0.01）,and no signifficant difference between group A and B was found（P〉0.05）.MVD and VEGF expression in group A were less than those in group B and C（P〈0.01）.Conclusion The rh-endostatain arterially administrated causes no damage of liver and renal function.The combination therapy of TACE and rh-endostatain is better at inhibiting liver cancer growth and tumor angiogenesis than single TACE.