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目的 评价经肝动脉化疗栓塞术(transarterial chemoembolization,TACE)治疗大鼠移植性肝癌中化疗药物的 抑瘤及肝损害作用。材料与方法 复制大鼠移植性肝癌模型,经肝动脉插管采取以下介入治疗方案:A组(小剂 量TACE,n=10):经肝动脉灌注丝裂霉素(MMC)50μg+超液态碘油(UFLP)50μl+明胶海绵粉(GF)25 μg;B组 (常规剂量TACE,n=10)经肝动脉灌注5-FU 5 mg+MMC 50μg+UFLP 50μl+GF 25 μg;C组(对照组,n=10)经肝 动脉灌注生理盐水0．3 ml,介入术前及术后12 d,分别行MRI检查测量肿瘤体积V1及V2,并计算、比较V2/V1,取 术后肿瘤及瘤周肝组织行病理学检查,并行肝功能检查。结果 存活27只大鼠,V2/V1比较结果:C组高于A、B 组,且均有显著性差异(P<0．05),而A、B两组无显著性差异(P>0．05);三组间肿瘤坏死程度分别为58．25％、 55．60％、26．67％,C组低于A、B组,均存在显著性差异(P<0.05),而A、B两组无显著性差异(P>0．05);三组间瘤 周肝组织改变分别为肝细胞胞浆疏松化、气球样变、无变性坏死;肝功能比较结果:A组谷丙转氨酶(ALT)、谷草转 氨酶(AST)水平高于C组(P<0．05),而B组又高于A组(P<0．05),A、C组间总胆红素(1TBIL)与白蛋白(ALB)水平 无显著性差异(P>0．05),但前者低于B组(P<0．05)后者高于B组(P<0．05)。结论 一定剂量化疗药的TACE 可有效治疗大鼠移植性肝肿瘤,增加化疗药剂量并不能增加这种作用,相反能明显加重对肝组织的损害及对肝功 能的影响作用。
Objective To evaluate the antitumor and hepatic impairment effects of transarterial chemoembolization (TACE) in the treatment of transplanted hepatocellular carcinoma in rats. MATERIALS AND METHODS Rat hepatocellular carcinoma (HCC) model was established and transcatheter hepatic arterial intubation was used to investigate the following interventions: Group A (low-dose TACE, n = 10): intramyocardial infusion of mitomycin (MMC) 5μg / MMC 50μg + UFLP 50μl + GF 25μg was injected intrahepatic artery in group B (conventional dose TACE, n = 10) n = 10). The animals were perfused with 0.3 ml normal saline through hepatic artery and the tumor volumes V1 and V2 were measured by MRI before intervention and 12 days after operation. Liver pathology examination, parallel liver function tests. Results There were 27 rats surviving. The results of V2 / V1 comparison were higher in group C than in groups A and B (P <0.05), but there was no significant difference in group A and B (P> 0 .05). The tumor necrosis rates of three groups were 58.25%, 55.60% and 26.67% respectively, there was a significant difference (P <0.05) between group C and group A, There was no significant difference between the two groups (P> 0.05). The changes of peri-hepatic tissue in the three groups were cytoplasmic loosening, balloon-like degeneration and no degeneration and necrosis respectively. Comparing the results of liver function: A group of alanine aminotransferase ALT and AST were significantly higher in group B than those in group C (P <0.05), while those in group B were significantly higher than those in group A (P <0.05). Total bilirubin (1TBIL) (P <0.05), but the former was lower than that of group B (P <0.05), while the latter was higher than that of group B (P <0.05). Conclusion TACE of certain doses of chemotherapy drugs can effectively treat rat transplanted liver tumors, increasing the dose of chemotherapy does not increase this effect, on the contrary can significantly aggravate the damage to liver tissue and its effect on liver function.