兔VX2胰腺癌模型冷冻消融治疗的研究

The cryoablation study of rabbit VX2 pancreatic carcinoma

目的 探讨合适的兔VX2胰腺癌模型以及最佳的冷冻消融方法.方法 采用VX2肿瘤组织接种兔胰腺建立VX2胰腺癌模型.实验兔采用随机区组法随机分为4组：治疗组A：术中冷冻范围包括胰腺肿瘤和癌旁组织;治疗组B：术中冰球直径与肿瘤直径一致;治疗组C：术中冰球直径小于肿瘤直径;对照组：只行开腹手术.监测各组实验兔冷冻前后血清特异性烯醇化酶（NSE）、C反应蛋白（CRP）和淀粉酶（AMY）水平变化以及记录生存期寻求最佳冷冻消融方法.结果 成功建立兔VX2胰腺癌模型,造模成功后28d血清中NSE水平增加至（88.43±15.25）ng/ml.冷冻后1d治疗组A、B 和C中NSE分别增加至（27.31±4.28）、（23.64±6.82）和（19.49±2.49）ng/ml,术后3d均逐渐降低,术后7d降至正常水平.对照组和治疗组A、B、C的中位生存期分别为29、40、52和35d,与对照组比较,治疗组A和C的生存期差异无统计学意义（P=0.080）,治疗组B生存期显著长于其他组（P=0.040、0.030、0.010）.结论 成功建立以NSE为肿瘤标志物的兔VX2胰腺癌模型,胰腺癌开腹冷冻消融法的最佳选择为术中冰球直径与肿瘤直径一致.

Objective To establish an appropriate animal model of pancreatic cancer, and choose the most suitable laparotomy.Methods To establish a VX2 pancreatic cancer model, VX2 tumor tissues were inoculated into rabbit pancreases.The rabbits were randomly divided into four groups by randomized block method： Control group, Group A （intraoperative frozen range includes pancreatic tumor and peritumoral tissues）, Group B （intraoperative frozen range was as big as the tumor）, and Group C （intraoperative frozen range was smaller than the tumor）.Monitoring serum neuron-specific enolase （NSE）, C-reaction protein （CRP） and amylase （AMY） levels before and after surgery and record survival in each group to seek the most appropriate method.Results The VX2 pancreatic carcinoma model was successfully established, NSE levels increased to （88.43±15.25） ng/ml after inoculation 28 d.NSE of group A, B and C significantly increased to （27.31±4.28）, （23.64±6.82） and （19.49±2.49） ng/ml at Day 1 after cryosurgery, decreased at Day 3, gradually reduced to normal levels after Day 7.The median survival of control group, group A, group B and group C was 29, 40, 52, 35 d.Compared with Control group, rabbits in Group A and C had no significant difference in survival time （P=0.080）, but Group B significantly prolonged the survival time （P=0.040, 0.030, 0.010）.Conclusion VX2 pancreatic cancer model was successfully established with NSE as a tumnor marker.Group B may be a suitable option for patients with unresectable pancreatic cancer.