碘油栓塞致大鼠肝肿瘤细胞凋亡和动态病理观察

Histopathological changes in rat transplanted hepatoma after lipiodol transarterial embolization

目的 研究经肝动脉碘油灌注栓塞后大鼠肝肿瘤病理学表现 ,观察肿瘤细胞凋亡情况。方法 4 1只Walker 2 5 6大鼠肝癌模型随机分为 6组 :对照组 6只大鼠经胃十二指肠肝动脉灌注 76 %泛影葡胺 0 .2～ 0 .3ml;实验组肝动脉灌注栓塞超液态碘油 0 .5ml/kg与泛影葡胺乳剂 (1∶1) ,按碘油栓塞后 0 ,1,3,5 ,10d分为 5组 ,每组 7只。光镜和透射电镜分别观察大鼠肝肿瘤组织病理 ,检测凋亡细胞。结果 与对照组比较 ,实验组大鼠的肿瘤增长率 (GR)受到抑制 ,栓塞 3d组GR为 2 8% ,对照组为 133%。 3～ 10d组肿瘤坏死程度加重 (P <0 .0 1) ,10d组有 1例完全坏死 ,栓塞后早期炎症反应明显 ,后期出现纤维包裹和分隔。 1～ 10d组有 17例大鼠的凋亡细胞计数为阳性 ,主要位于肿瘤周边 ,呈典型细胞凋亡形态学特征。结论 经肝动脉单纯灌注栓塞碘油可引起大鼠肝肿瘤不同程度坏死 ,诱导肿瘤细胞凋亡可能是其另一种重要作用机制。

Objective To study the histopathological effect of hepatic arterial infusion of lipiodol on transplanted hepatoma in rats. Methods Fourty-one rats bearing Walker-256 transplanted hepatoma were randomly divided into embolization group (n=35,divided in 5 subgroups,with 7 rats in each) and control group (n=6). Lipiodol(0.5 ml/kg)emulsified with 0.2～0.3 ml of 76% urografin (v:v=1∶1) was infused via gastroduodenal artery into hepatic artery in embolization group. Rats in the control group were given via the same route urografin only. Histopathological changes of the treated tumors were examined by light and transmission electron microscopy. Results In the control rats treated with urografin alone,the average tumor size increased 2.8 fold on day 3,while that in the lipiodol treated rats increased 1.7 fold (P<0.01). Compared with the control group,on day 3,5,10 after embolization treatment,tumor necrosis was more extensive (P<0.01). In one of the treated rats,the tumor was completely necrotic on day 10. Inflammatory reaction was marked in the early post-embolic period,but it was replaced by fibrous tissue encapsulation . From day 1 on,in 17 of the 18 treated rats,apoptotic cells,identified by typical morphology under light and electronic microscopes,were observed,mainly in the tumor periphery. Conclusion In addition to cellular necrosis,apoptosis may be another important mechanism leading to cell death in hepatoma treated with transarterial embolization.