联合丝裂霉素、碘油及肝动脉栓塞对大鼠肝癌的介入治疗

Combined use of mitomycin,lipiodol and hepatic artery ligation for treating liver cancer in rats

目的:建立Walker256大鼠肝癌模型,探讨碘油、栓塞及化疗在肝动脉化疗栓塞术中的作用.方法:将皮下种植生长出的Walker256细胞瘤结节切成约1.5mm3大小的瘤块,植入35只♂SD大鼠肝包膜下,植入后9d用磁共振(magnetic resonance imaging,MRI)测量肿瘤体积V1,经胃十二指肠动脉逆行插管至肝动脉注入不同药物,分为实验组:A组(n=7),0.1mg丝裂霉素(mitomycin,MMC)+0.1mL碘油(lipiodol,LP)+肝动脉结扎(hepatic artery ligation,HAL);B组(n=7),0.1mg MMC+0.1mL LP;C组(n=7),0.1mg MMC+HAL;D组(n=7),0.1mL LP+HAL;对照组:E组(n=7),0.1mL0.9%生理盐水.介入术后9d采用MRI测量肿瘤体积V2及肿瘤增长率(V2/V1).结果:介入治疗术前,A、B、C、D、E各组肿瘤平均体积V1分别为:0.017cm3±0.008cm3、0.019cm3±0.011cm3、0.022cm3±0.010cm3、0.019cm3±0.008cm3、0.021cm3±0.006cm3,术后肿瘤平均体积V2分别为:0.038cm3±0.017cm3、0.152cm3±0.069cm3、0.302cm3±0.134cm3、0.382cm3±0.049cm3、0.715cm3±0.307cm3.肿瘤平均增长率V2/V1分别为:2.50±1.08、8.73±2.38、14.66±4.96、21.26±5.19、33.10±8.17.治疗后A、B、C、D各实验组肿瘤平均增长率明显低于对照组E组(P<0.05);A、B、C、D各组间两两比较肿瘤平均增长率也具有显著性差异(P<0.05).结论:丝裂霉素与碘油及肝动脉结扎(LP+MMC+HAL)三者联合应用治疗肝癌取得了满意的疗效,较其中任2种联合应用有明显优势,有较好的临床应用前景.

AIM：To establish a rat model of Walker 256 liver cancer to evaluate the role of embolic agents,lipiodol（LP） and chemotherapeutic agents in transcatheter arterial chemoembolization.METHODS：Subcapsular implantation of carcinoma tissue of Walker 256 in the liver was carried out in 35 male SD rats.Tumor volume（V1） was measured by magnetic resonance imaging（MRI） on day 9 after implantation.All rats were randomly divided into experiment groups and control group by the agents which were injectd via the gastroduodenal artery to hepatic artery.The experiment groups included group A（n = 7）,mitomycin（MMC,0.1 mg） ＋ LP（0.1 mL） ＋ hepatic artery ligation（HAL）;group B（n = 7）,MMC（0.1 mg） ＋ LP（0.1 mL）;group C（n = 7）,MMC（0.1 mg） ＋ HAL;group D（n = 7）,LP（0.1 mL） ＋ HAL.The control group（group E,n = 7） was given 0.9% NaCl（0.1 mL）.Tumor volume（V2） was assessed by MRI（on day 9 after treatment） and the growth ratio of tumor（V2/V1） was calculated.RESULTS：The mean tumor volume before and after treatment was 0.017 cm3 ± 0.008 cm3,0.038 cm3 ± 0.017 cm3;0.019 cm3 ± 0.011 cm3,0.152 cm3 ± 0.069 cm3;0.022 cm3 ± 0.010 cm3,0.302 cm3 ± 0.134 cm3;0.019 cm3 ± 0.008 cm3,0.382 cm3 ± 0.049 cm3;and 0.021 cm3 ± 0.006 cm3,0.715 cm3 ± 0.307 cm3 in groups A,B,C,D and E,respectively.The tumor growth ratio（V2/V1） was 2.50 ± 1.08,8.73 ± 2.38,14.66 ± 4.96,21.26 ± 5.19,33.10 ± 8.17 in groups A,B,C,D and group E,respectively.The tumor growth ratio was significantly lower in the experiment groups than in the control group（all P 〈 0.05）.There were significant differences in the tumor growth ratio among groups A,B,C and D（all P 〈 0.05）.CONCLUSION：Combined use of mitomycin,lipiodol and hepatic artery ligation could achieve satisfactory results in the treatment of liver cancer.