不同浓度乙醇消融VX2兔移植性肝肿瘤的实验研究

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目的探讨不同浓度乙醇经皮瘤内注射(PEI)疗法对兔移植型肝癌的治疗效果。方法31只新西兰兔肝内植入VX2瘤块(1 mm3),移植后14 d行CT扫描,测量肿瘤体积。然后采取以下治疗:A组经皮瘤内注射无水乙醇(9只)、B组注射75%乙醇(9只)、C组注射50%乙醇(9只)、D组未予任何处理(对照组,4只)。治疗后7、14、21 d分别行CT、MRI扫描,观察病灶的变化并测量大小,每组处死2只取病理观察肿瘤大小、光镜下观察肿瘤的凝固性坏死与对照组比较,治疗后60d内观察各组生存期的长短。结果PEI治疗前和治疗后21 d肿瘤体积之比分别为:A组1.68、B组1.75、C组5.81、D组8.72。与对照组相比,C组抑制肿瘤生长的无显著性差异(P>0.05),A、B组均能抑制肿瘤的生长(P<0.01,P<0.01),且A组与B组抑制肿瘤生长的无显著性差异(P>0.05)。平均生存时间为:A组(53.7±6.3)d,B组(52.8±7.4)d,C组(46.3±5.2)d,D组(34.1±3.7)d。治疗组病理切片光镜下肿瘤凝固性坏死范围随乙醇浓度的增加而增大。结论PEI可抑制肿瘤的生长,延长荷瘤兔的生存期,且随着乙醇浓度的升高生存期延长,75%以上浓度乙醇治疗效果的差异无统计学意义,但高浓度(≥75%)乙醇比低浓度(<75%)乙醇能明显抑制肿瘤的生长,延长生存期。 Objective To investigate the therapeutic effect of transcutaneous intratumoral injection (PEI) with different concentrations of ethanol on rabbit transplanted hepatocellular carcinoma. Methods 31 New Zealand rabbits were implanted with VX2 tumor mass (1 mm3) intrahepatic implants. CT scan was performed 14 days after transplantation to measure tumor volume. Then, the following treatments were adopted: group A received percutaneous intratracheal injection of ethanol (9), group B received 75% ethanol (group 9), group C received 50% ethanol (group 9), and group D received no treatment Group, 4). At 7, 14 and 21 days after treatment, CT and MRI scans were performed respectively to observe the changes of lesion size and measure the size of the lesion. Two of them were sacrificed to observe the size of the tumor pathologically. The coagulation necrosis of the tumor was observed under the light microscope as compared with the control group. The duration of survival in each group was observed within 60 days. Results The tumor volumes of PEI before treatment and after 21 days of treatment were 1.68 in group A, 1.75 in group B, 5.81 in group C and 8.72 in group D, respectively. Compared with the control group, there was no significant difference (P> 0.05) in the inhibition of tumor growth in group C, and the growth of group A and B were inhibited (P <0.01, P <0.01) No significant difference in growth (P> 0.05). The average survival time was 53.7 ± 6.3 days in group A, 52.8 ± 7.4 days in group B, 46.3 ± 5.2 days in group C and 34.1 ± 3.7 days in group D, respectively. The range of tumor coagulation necrosis increased with the increase of ethanol concentration in the pathological section of the treatment group. Conclusions PEI can inhibit the growth of tumor and prolong the survival of tumor-bearing rabbits. With the increase of ethanol concentration, the survival time is prolonged. There is no significant difference in the effect of ethanol treated with PEI of 75% Ethanol significantly inhibited tumor growth and prolonged survival compared to ethanol at low concentrations (<75%).
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