选择性胆管栓塞与选择性门静脉栓塞对大鼠肝癌模型影响的实验研究

EXPERIMENGTAL STUDY OF SELECTIVE BILE DUCT EMBOLIZATION AND SELECTIVE PORTAL VEIN EMBOLIZATION FOR LIVER CANCER MODEL IN RATS

目的观察选择性门静脉栓塞和选择性胆管栓塞对大鼠种植性肝癌模型肿瘤及未栓塞侧肝组织影响。方法建立Walker-256大鼠移植性肝癌模型,随机分为三组,每组20只,分别进行选择性门静脉栓塞、选择性胆管栓塞及单纯剖腹手术(对照组),于术后1、2、3、4周各处死5只大鼠,检测肝叶重量、肿瘤大小和肝功能;免疫组织化学法检测瘤组织中Ki67表达,计算Ki67阳性率。CD31标记血管内皮细胞测肿瘤微血管密度。根据资料不同分别应用单因素方差分析和q检验进行统计学分析。结果选择性门静脉栓塞组、选择性胆管栓塞组与对照组比较,大鼠ALT、AST升高,未栓塞侧肝脏体积增大,P值均<0.05或<0.01。选择性门静脉栓塞组大鼠肝癌体积及癌组织Ki67阳性率大于其余两组(P<0.05),选择性胆管栓塞组与对照组差异无统计学意义(P>0.05)。微血管密度值三组间差异无统计学意义(P>0.05)。结论选择性胆管栓塞和选择性门静脉栓塞均能够增加未栓塞侧肝体积,选择性门静脉栓塞效果更佳。选择性门静脉栓塞可促进栓塞侧大鼠移植性肝癌生长,选择性胆管栓塞对大鼠肿瘤生长无影响。

Objective To investigate the effects of selective bile duct embolization and selective portal vein embolization on tumor and contra lateral liver in rats with transplanted liver cancer.Methods 60 Sprague-Dawley rats were implanted Walker-256 carcinosarcoma in their livers,and were divided into 3 groups randomly.Respectively selective portal vein embolization,selective bile duct embolization and laparotomy alone,after embolization in 1,2,3,4 weeks each executed five rats,testing in general,histology,tumor size,liver function,tumor tissue Ki67 expression were detected by immunohistochemistry,antiangiogenetic effects were assessed by CD31 immunostaining.Results The rats,serum AST 、ALT and noneembolization liver volume were rise in rats treated by selective portal vein embolization and selective bile duct embolization（P〈0.01 or P〈0.05）.Selective portal vein embolization in rats liver volume and Ki67-positive rate of cancer than the other two groups（P〈0.05）,selective bile duct embolization group and control group no statistically significant difference（P〉0.05）.There was no significant difference of the intratumoral microvessel density （MVD） among 3 groups（P〉0.05）.Conclusion Selective portal vein embolization and selective bile ducts embolization were able to increase none-embolization liver volume,selective portal vein embolization have better efficacy.Selective portal vein embolization can promote rat transplanttation liver tumor growth,selective bile duct embolization do not influence rat transplantation liver tumor growth.