^(125)I粒子植入在肝组织应用中的实验评估  

Safety evaluation of iodine-125 seed implantation in rabbit liver tissue

作　　者：梅雀林[1] 刘鹏程[1] 杨建勇[2] 杜端明[1] 陈在中[1] 

机构地区：[1]北京大学深圳医院影像中心,广东深圳518036 [2]中山大学附属第一附属医院介入放射科,广东广州510080

出　　处：《南方医科大学学报》2007年第5期675-678,共4页Journal of Southern Medical University

基　　金：吴阶平医学科研基金(320.6720.0501);深圳市科技计划项目(200404093)~~

摘　　要：目的探讨放射性粒子植入肝脏的安全性。方法新西兰大白兔20只,随机分为治疗组和对照组。治疗组经皮肝植入放射活性为37MBq的125I粒子2粒,对照组肝脏内植入无表面活性的空心粒源2粒。粒子植入后4周,处死动物,行HE染色和原位细胞凋亡检测,比较各组大白兔植入前和植入后1个月内周围血像、肝功能、肾功能的变化。结果组织学检查显示有活性粒源周围的肝组织可见大片状凝固性坏死,距粒源5mm处变性坏死的肝细胞与正常细胞间出现一条较为明显的分界带;无活性粒源周围肝组织结构正常。原位凋亡检侧显示,在放射性粒源周围肝组织内可见一条明显的凋亡细胞带,而空心粒源周围肝组织内未检测出凋亡细胞。粒子植入术后2周,治疗组谷丙转氨酶明显升高(t=6.285,P<0.001),但4周后降至正常水平(t=2.002,P=0.06)。谷草转氨酶、总胆红素、血肌酐、尿素氮、血红蛋白浓度、白细胞和血小板计数粒子植入前后无明显变化。结论125I粒子植入的剂量分布具有适形性,在肝组织中植入放射性粒子对重要脏器功能无明显影响,提示在肝肿瘤组织中植入粒子是一种较为安全的微创技术。Objective To evaluate the safety of iodine-125 seed implantation in the liver. Methods Twenty New Zealand rabbits were divided into control and treatment groups and in the latter, iodine-125 seeds of 37 MBq were implanted into the liver under CT guidance whereas nonradioactive seeds were implanted in the control rabbits. Four weeks after implantation, white blood cell count, liver functions, and renal functions were measured or evaluated for comparison with those before implantation. The rabbits were then anesthetized to collect the liver tissue for pathological examination with HE staining and cell apoptosis assay. Results Obvious hepatic tissue necrosis was observed around the radioactive seeds in the treatment group. At a 5 mm distance to the seeds, a distinct boundary occurred between the necrotic hepatic cells and normal cells. The control rabbits, however, had normal liver structure around the seeds implanted. In situ cell apoptosis examination showed a distinct band ofapoptotic cells in the liver tissue of rabbits in the treatmen/t group, which was not found in the control group. Two weeks after iodine-125 irradiation, alanine aminotransferase significantly increased in the treatment group （t=6.285, P〈 0.001）, but recovered two weeks later 0=2.002, P=0.06）. No significant alterations occurred in aspartate aminotransferase, blood urea nitrogen, serum creatinine, hemoglobin, serum total bilirubin, white blood cell count, or platelet count after the seed implantation. Conclusion Iodine-125 seed implantation in the liver results in conformal irradiation dose distribution without obvious effects on the vital organs, demonstrating iodine-125 seed implantation as a safe and minimally invasive technique for hepatic cancer treatment.

关 键 词：碘放射性同位素 组织间植入 肝脏 毒性 凋亡 

分 类 号：R817[医药卫生—影像医学与核医学]