肝动脉 门静脉化疗栓塞治疗兔VX2肝癌后残癌新生血管的研究

Study on neovascularization in residual carcinoma of rabbit VX2 liver tumor after hepatic artery and portal vein chemoembolization

目的研究经导管肝动脉化疗栓塞(TACE)联合选择性门静脉栓塞(SPVE)治疗兔VX2肝癌对残癌组织新生血管生成的影响。方法 42只实验兔,采用随机数表法分为实验组(A组)和对照组(B组),每组21只。A组行TACE联合SPVE治疗,B组单纯行TACE治疗。A、B两组于第14、21天,行CT平扫+增强扫描,第15天行TACE治疗,第18天分别行SPVE和门静脉数字减影血管造影(DSA)检查,第22天开腹行直接穿刺肝动脉和门静脉DSA检查并处死,取肿瘤周边残癌组织,检测血管内皮细胞生长因子(VEGF)及微血管密度(MVD)的表达情况。结果 A组VEGF、MVD值分别为(120.7±10.99)、(58.9±9.05),B组VEGF、MVD值分别为(136.5±15.45)、(71.8±12.06),两组差异均有统计学意义(P<0.05)。结论门静脉对周边的肝癌组织具有部分血供,且TACE联合SPVE能够提高肿瘤的坏死程度,抑制新生血管的生成。

ObjectiveTo investigate the effect of neovascularization in residual carcinoma of the rabbit VX2liver tumor after transcatheter arterial chemoembolization(TACE)combined with selective portal vein embolization(SPVE).Methods Forty-two rabbits were randomly divided into two groups.The experimental group(group A)was treated with a combination of TACE and SPVE while the control group(group B)was treated with TACE alone.All the rabbits underwent plain and enhanced CT scanning on the14th and21st day after tumor implantation.On15th day they were carried out TACE treatment.On18th day the rabbits in group A and group B respectively underwent SPVE and portal vein DSA examination.On22nd day the remaining rabbits were implemented laparotomy and the hepatic artery and portal vein were directly punctured for DSA examination and then sentenced to death.The expression of vascular endothelial growth factor(VEGF)and microvessel density(MVD)in survival cancerous tissues were detected.Results The value of VEGF and of MVD in group A was(120.70±10.99)and(58.90±9.05)respectively,and the levels of VEGF and MVD in group B were(136.50±15.45)and(71.80±12.06)respectively.The difference between the two groups was statistically significant(P<0.05).Conclusion Portal veins supply blood to the periphery of liver cancer tissues and TACE combined with SPVE can improve the degree of tumor necrosis and inhibit angiogenesis.