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目的 观察暂时阻断肝静脉行肝动脉化疗栓塞术 (TACE -THVO)的疗效 ,对比阿霉素碘油 ,无水乙醇碘油化疗栓塞剂对移植瘤的作用。方法 建立 75只肝内移植性肝癌大鼠模型 ,随机将其分为 5组 ,设立对照 ,暂时阻断肝静脉后 ,用 2种不同的化疗药物碘油栓塞剂行肝动脉化疗栓塞术。 1周后 ,处死实验大鼠 ,观察大体标本与光镜下苏木素 -伊红染色病理切片的移植瘤缩小和坏死状况 ;苏丹Ⅲ染色切片光镜及扫描电镜观察药物碘油栓塞剂沉积部位与瘤细胞超微结构改变。结果 经肝动脉化疗栓塞治疗各组瘤灶体积均缩小。TACE -THVO试验组的肿瘤生长率小于未阻断肝静脉行肝动脉化疗栓塞的对照组 ;试验组肿瘤坏死范围和门静脉碘油沉积例数高于对照组 ;应用阿霉素碘油栓塞剂行肝动脉化疗栓塞术组的肿瘤坏死范围小于用无水乙醇碘油栓塞剂组 ;试验组中肿瘤细胞粗面内质网出现空泡变性 ,瘤细胞核内出现脂滴样物质 ,细胞核崩解。结论 用无水乙醇碘油做化疗栓塞剂经肝动脉栓塞移植性肝癌 ,其肿瘤的坏死范围高于用阿霉素碘油栓塞剂 ,TACE -THVO有可能成为治疗肝癌的一种有效方法。
Objective To observe the curative effect of transcatheter hepatic arterial chemoembolization (TACE-THVO) temporarily and to compare the effects of doxorubicin lipiodol and absolute ethanol iodized oil chemoembolization on transplanted tumor. Methods A total of 75 rat models of intrahepatic transplantation of hepatocellular carcinoma were established and randomly divided into 5 groups. After the establishment of the control, hepatic artery chemoembolization was performed with two different chemotherapeutic drugs, lipiodol embolization, after temporarily blocking the hepatic vein. One week later, the experimental rats were killed to observe the shrinkage and necrosis of the transplanted tumor in hematoxylin-eosin staining sections under gross and light microscopy. The sections of the tumors treated with lipiodol embolization agent and the tumor Cell ultrastructure changes. Results Transcatheter arterial chemoembolization (TACE) reduced the tumor volume in all groups. TACE-THVO experimental group tumor growth rate was less than did not block the hepatic artery chemoembolization in the control group; the experimental group tumor necrosis and portal vein lipiodol deposits were higher than the control group; the application of doxorubicin lipiodol embolization agent line The extent of tumor necrosis in the hepatic artery chemoembolization group was smaller than that in the embolization group treated with lipiodol. In the experimental group, vacuolar degeneration was found in the rough endoplasmic reticulum of the tumor cells. Lipid droplet-like substance appeared in the nucleus of tumor cells and the nucleus collapsed. CONCLUSION: TACE-THVO may be an effective method for the treatment of hepatocellular carcinoma with chemotherapeutic embolization of ethanol-free lipiodol via transhepatic arterial embolization of transplanted hepatocellular carcinoma. The extent of tumor necrosis is higher than that of doxorubicin lipiodol embolization.