经肝动脉化疗栓塞术联合射频消融治疗兔肝VX2肿瘤的效果分析

Clinical effect of transarterial chemoembolization combined with radiofrequency ablation in treatment of rabbit VX2 liver tumors

目的观察经肝动脉化疗栓塞术(TACE)联合射频消融(RFA)以及单独应用对兔肝VX2肿瘤的效果及病理学改变。方法将18只建模成功的荷瘤兔平均分为3组,每组6只:TACE+RFA治疗组(TACE后15 min采用RFA治疗),单独行TACE治疗组和单独行RFA治疗组。术后7 d处死实验兔,比较肿瘤区凝固性坏死区或出血性性梗死区的最大切面积,对比典型的病理切片。计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验。结果 RFA组中1只实验兔死于术中气胸;术后2 d TACE+RFA组中1只实验兔死于大面积肝坏死。16只实验兔存活至观察点结束,实验成功率为88.9%(16/18)。TACE+RFA组中的凝固性坏死最大长径、短径和肿瘤细胞坏死率与其他2组比较,差异均有统计学意义(P值均<0.05)。病理分析显示,TACE+RFA组和其他组相比具有更多的血管栓塞及坏死区、较少的岛屿状存活肿瘤细胞群。结论 TACE+RFA较单独应用RFA和TACE能够收获更好的肿瘤毁损效果。

Objective To investigate the clinical effect of transarterial chemoembolization（TACE） combined with radiofrequency ablation（RFA）（TACE ＋ RFA） versus RFA or TACE alone in the treatment of rabbit VX2 hepatic tumors and related pathological changes.Methods The rabbits were sacrificed at 7 days after surgery,and the maximal diameter of coagulative necrotic zone or hemorrhagic infarct zone was compared,as well as typical pathological sections.An analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results One rabbit in the RFA group died of pneumothorax and one in the TACE ＋ RFA group died of extensive liver necrosis at 2 days after surgery.The other 16 rabbits survived to the end of observation,resulting in a success rate of 88.9%（16/18）.There were significant differences between the TACE ＋ RFA group and the other two groups in the maximal long and short diameters of coagulative necrotic zone and tumor cell necrosis rate（all P 〈 0.05）.The pathological analysis revealed greater vascular thrombosis,larger necrotic zone,and fewer clusters of viable tumor cells in the TACE ＋ RFA group,compared with the other groups.Conclusion TACE ＋ RFA has a better effect in tumor destruction than RFA or TACE alone.