CT引导下乙醇消融VX2兔移植型肝肿瘤

CT guided percutaneous ethanol injection of transplanted liver VX2 tumor on rabbits

目的观察不同浓度乙醇经皮瘤内注射疗法对兔移植型肝癌的疗效及病理改变。方法32只新西兰荷瘤兔,以完全随机法分为4组,每组8只,在CT引导下经皮穿刺瘤内注射不同浓度乙醇,分别为:无水乙醇、75%乙醇、50%乙醇,对照组注射生理盐水。观察治疗后7 d、14 d、21 d和60 d各组肿瘤的大小及影像学和病理学变化。结果治疗后21 d,各组肿瘤体积分别为:无水乙醇组(4.68±5.05)cm3,75%乙醇组(6.33±6.59)cm3,50%乙醇组(17.54±5.06)cm3,对照组(16.87±5.27)cm3;对照组较75%乙醇组(t=6.32,P<0.05)和无水乙醇组(t=6.74,P<0.05)体积明显增大;50%乙醇组较75%乙醇组(t=4.99,P<0.05)和无水乙醇组(t=12.77,P<0.05)体积明显增大;50%乙醇组与对照组、75%乙醇组与无水乙醇组比较差异均无统计学意义(P均>0.05)。治疗后1 d,ALT、AST均有升高;7 d后除无水乙醇组外,其他各组均恢复到正常范围;无水乙醇组ALT、AST高于其他各组(t=4.10、4.49、3.06、5.79、5.91、4.11,P均<0.05),其余各组间差异无统计学意义。肿瘤凝固性坏死范围随乙醇浓度的增加而增大。结论75%乙醇和无水乙醇均有明显的抑瘤作用,但75%乙醇对肝功能的损伤较小,为兔VX2肝癌模型较适宜的治疗浓度。

Objective To evaluate the therapeutic effects and pathologic changes of VX2 liver tumor in rabbits treated with CT-guided percutaneous ethanol injection（PEI） with different concentration.Methods Thirty-two New Zealand rabbits with VX2 liver tumor were randomly divided into 4 groups（each n=8）,i.e.anhydrous ethanol,75% ethanol,50% ethanol and control group（administrated physiological saline）.Tumor size,imaging and pothologic changes were observed 7 d,14 d,21 d and 60 d after PEI.Results The volume was（4.68±5.05） cm3 in anhydrous ethanol group,（6.33±6.59） cm3 in 75% ethanol group,（17.54±5.06） cm3 in 50% ethanol group and（16.87±5.27） cm3 in control group 21 d after PEI.Tumor size in control group was larger than that in 75% ethanol group（t=6.32,P〈0.05） and anhydrous ethanol group（t=6.74,P〈0.05）,in 50% ethanol group was larger than that in 75% ethanol group（t=4.99,P〈0.05） and anhydrous ethanol group（t=12.77,P〈0.05）.No difference of tumor size was found between 50% ethanol group and control group,nor between 75% ethanol group and anhydrous ethanol group.ALT and AST both increased in all groups 1 d after PEI and returned to normal 7 d later except anhydrous ethanol group.ALT and AST in anhydrous ethanol group were higher than those in other groups（t=4.10,4.49,3.06,5.79,5.91,4.11,all P〈0.05）,and no difference of ALT and AST was detected between other groups.Area of coagulation necrosis enlarged with the increase of ethanol concentration.Conclusion Anhydrous ethanol and 75% ethanol both have obvious inhibition function to the rabbit VX2 tumor,while 75% ethanol has little damage to the liver function and is suitable for PEI.