羟基乙酸乙基纤维素微球经肝动脉栓塞治疗兔肝肿瘤

Hepatic arterial embolization with glycolic acid-ethylcellulose microspheres in treatment of hepatic tumor in rabbits

目的评价羟基乙酸乙基纤维素微球对兔VX2肝肿瘤的介入治疗作用。方法将30只新西兰大白兔制作成VX2兔肝肿瘤模型,造模后13 d行CT检查,计算荷瘤兔肿瘤体积,按肿瘤体积大小进行编号,采用随机数字表法分为A、B、C 3组,每组10只。所有动物经右侧股动脉插管至肝动脉,行造影后向肿瘤供血动脉给药:A组注入羟基乙酸乙基纤维素微球1 ml(0.023 g),B组注入碘油1 ml,C组注入生理盐水1 ml。记录实验动物介入治疗前后肝功能、肝脏肿瘤体积变化,观察各组治疗后肝肿瘤病理变化,从每组中随机选择5只观察生存期。结果介入治疗前各组肝功能、肿瘤体积无统计学差异;介入治疗1周后,A、B组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平均高于C组(P<0.05);CT测量显示A、B组肿瘤生长率低于C组(P<0.01),且A组较B组更低(P<0.01)。H-E染色显示A组及B组肿瘤纤维组织包膜增厚,癌巢中央大片坏死,癌细胞排列松散,细胞核明显固缩,病理性核分裂减少;免疫组化染色显示A组的VEGF表达和PCNA增殖活性弱于B组。A组生存时间较B、C组延长(P<0.05,P<0.01)。结论羟基乙酸乙基纤维素微球肝动脉栓塞对VX2兔肝肿瘤有良好的治疗效果,使用安全。

Objective To evaluate the therapeutic effects of glycolic acid-ethylcellulose microspheres infused via hepatic artery on hepatocarcinoma in rabbits. Methods Thirty New Zealand white rabbits were implanted with VX2 liver tumor and received CT examination after 13 days. The tumor volumes were calculated; the tumors were numbered according to volume and were divided into 3 groups by random number table. 3 F catheters were inserted via right femoral artery to hepatic artery in all animals; the nutrition arteries of the tumor were observed by injecting contrast media; and then therapeutic agents were given through the catheter. Group A （n=10） was given glycolic acid-ethylcellulose microspheres （0. 023 g/1 ml）, Group B （n= 10） was given lipiodol （1 ml）, and Group C （n= 10） was given normal saline （1 mt）. The liver function and tumor growth were observed before and after treatment; the pathological changes of tumor tissues and the survival of rabbits were observed with 5 randomly selected animals in each group. Results The liver function and the tumor volumes were not significantly different among groups. One week after treatment, AST and ALT levels were significantly higher in Group A and B compared with those in Group C （P〈0.05）. CT results showed that the tumor growth rates in group A and B were significantly smaller than that in Group C （P〈0.01）, and that in group A was significantly smaller than that in Group B（P〈0.01）. Pathological examination showed greatly thickened tumor fibrous capsule and large necrotic area in tumors in Group A and B, with loosely arranged tumor cells, pyknosis and greatly decreased pathologic mitosis. VEGF expression and proliferation activity in Group A were weaker than those in Group B. Compared with Group B and C, animals in Group A had a significantly longer survival time compared with group B and C（P〈0.05, P〈0.01）. Conclusion Transcatheter infusion of glycolic acid-ethylcellulose microspheres is a safe and effective chemoembolization agent for treatment of rabbit hepatic tumors.