^(32)P-GMS在肝动脉放射性栓塞化疗治疗肝癌中的作用

Hepatoartery Radioembolism-chemotherapy in Treatment of Hepatic Carcinoma

目的 研究3 2 磷 玻璃微球 ( 3 2 P GMS)在肝动脉放射性栓塞化疗治疗肝癌中的作用。方法 将3 2 P GMS与碘油混悬液直接注入 44只裸鼠人肝细胞癌负荷瘤内 ,观察瘤体的组织学反应及多药耐药基因 (MDR )表达的P 蛋白变化。对 2 2例肝细胞癌患者 (Ⅰ组 )采用常规肝动脉栓塞化疗治疗 ;2 4例肝癌患者 (Ⅱ组 )采用3 2 P GMS与肝动脉栓塞化疗联合治疗。结果 鼠负荷瘤在吸收剂量达 770～ 30 80cGy时 ,肿瘤生长抑制率达 6 1.6 6 %～ 90 .41%。MDR表达的P 蛋白阳性表达率也相应降低。Ⅰ组患者肝内病灶缩小 ,有效率达 5 9.0 9% ( 13/2 2 ) ;Ⅱ组患者有效率达 83.33% ( 2 0 /2 2 ) ,P <0 .0 5。结论 3 2 P GMS局部照射与化疗药物联合治疗 ,可提高肝癌患者肝动脉栓塞化疗的疗效 ,其机制可能与3 2 磷局部照射影响MDR表达有关。

Objective To investigate the effect of phosphorus-32 glass microspheres(~ 32P-GMS) hepatoartery radiologic chemoembolism on hepatocellular cancer.Methods ~ 32P-GMS amalgamated in iodine oil was injected directly into the tumor mass of human hepatocellular cancer cell bearing nude mouse model(44).The histological reactions of tumor mass and multidrug resistance(MDR) expressed p-glycoprotein were observed.Twenty-two patients with hepatocellular cancer(group Ⅰ) received rutine hepatoartery embolizative chemotherapy; 24 patients(groupⅡ) were treated with ~ 32P-GMS and chemoembolism in the same way.Results In the animal bearing tumors the mass decreased markedly and the inhibitive rates attained 61.66%～90.41% in the absorbed doses ranged from 770～3 080 cGy.MDR expressed p-glycoprotein decreased in the cells.In the patients of group Ⅰ,the foci decreased in size dramatically with effective rate of 59.09%,compared with 83.33% in the group Ⅱ(P<0.05).Conclusion Conjugated administration of the local radiation with ~ 32P-GMS and chemotherapeutics injected by intra hepatic artery might strengthen the effect of hepatoartery chemoembolization on hepatocellular cancer.The enhancing effects may be related with the local action of ~ 32P on MDR expressed P-glycoprotein.