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目的:观察乏氧放射增敏剂甘氨双唑钠(CM)的应用能否提高肝动脉栓塞(TAE)结合外放射治疗肝肿瘤的效果。方法: 采用大鼠肝内移植Walker256 肿瘤模型,以肝动脉结扎(HAL)的方法阻断肝动脉血供,模拟TAE 治疗。荷瘤大鼠分为对照组、HAL组、HAL+外放射(RT)组、HAL+RT+CM组。观察治疗后肝内肿瘤的大小变化,冷冻切片观察肝肿瘤的坏死情况,原位杂交法检测肿瘤组织VEGF mRNA表达水平,石蜡切片观察肺转移灶情况。结果:与对照组相比,HAL+RT组、HAL+ RT+ CM组的肿瘤体积明显缩小,P<0 .01, HAL+RT+CM组肿瘤体积较HAL+RT组进一步缩小,但差异无统计学意义,P> 0. 05。与对照组相比,仅HAL+RT+CM组肿瘤坏死程度明显加重,P<0 05。与对照组相比,HAL组VEGF mRNA表达水平无明显改变,而HAL+RT、HAL+RT+CM组表达水平明显下降,P<0 .05。各组间肺转移率差异无统计学意义,P<0 .05。结论:在肝动脉阻断结合外放射综合治疗中加入CM促进肿瘤的坏死,并有进一步缩小肿瘤体积的趋势;对VEGFmRNA表达与肺转移率无明显影响。
Objective: To observe whether the application of hypoxia radiosensitizer sodium glycididazole (CM) can improve the efficacy of transcatheter arterial embolization (TAE) in combination with external radiotherapy in the treatment of liver tumors. Methods: The model of Walker256 tumor in rats was transplanted into the liver and hepatic artery occlusion (HAL) was used to block the hepatic artery blood supply and simulate TAE treatment. Tumor-bearing rats were divided into control group, HAL group, HAL + external radiotherapy (RT) group, HAL + RT + CM group. The changes of intrahepatic tumor size were observed after treatment. The necrosis of liver tumor was observed by frozen section, the expression of VEGF mRNA in tumor tissue was detected by in situ hybridization, and the metastasis of lung was observed by paraffin section. Results: Compared with the control group, the tumor volume of HAL + RT group and HAL + RT + CM group was significantly reduced (P <0.01). The tumor volume of HAL + RT + CM group was further reduced compared with HAL + RT group, but the difference was not statistically significant Meaning, P> 0.05. Compared with the control group, only the HAL + RT + CM group tumor necrosis significantly increased, P <0 05. Compared with the control group, the expression level of VEGF mRNA in HAL group had no significant change, while the expression level in HAL + RT, HAL + RT + CM group decreased significantly (P <0.05). There was no significant difference in lung metastasis rate between groups (P <0.05). CONCLUSION: CM can promote the necrosis of the tumor in the combined treatment of occlusion of hepatic artery and external radiation, and have the tendency of further reducing the tumor volume. There is no significant effect on the expression of VEGF mRNA and the rate of lung metastasis.