单侧肺动脉化疗性栓塞术在转移性肺癌模型中的应用  

Application of unilateral pulmonary arterial chemoembolization in treating experimental pulmonary metastases

作　　者：吴安乐[1] 颜志平[2] 周康荣[2] 王建华[2] 刘清欣[2] 罗剑钧[2] 陈颐[2] 

机构地区：[1]浙江省宁波市第一医院影像科DSA室,宁波市影像医学研究所,315010 [2]复旦大学附属中山医院放射科,上海市影像医学研究所

出　　处：《介入放射学杂志》2007年第10期688-692,共5页Journal of Interventional Radiology

基　　金：卫生部博士点基金资助项目(9741)

摘　　要：目的探讨选择性肺动脉化疗性栓塞治疗肺转移瘤的可行性和疗效,并通过碘油示踪阐明微小肺转移瘤的肺动脉供血情况。方法实验采用新西兰大白兔14只,建立血源转移性肺癌模型。分为3组,A组(4只)作为对照组,B组(4只)和C组(6只)为实验组。所有兔均在全麻下分离股静脉,采用3F微导管行选择性左肺动脉灌注治疗:A组灌注生理盐水5ml;B组灌注表阿霉素(2mg/kg)和卡铂(15mg/kg);C组灌注卡铂(15mg/kg),同时将超液态碘油1ml和表阿霉素(2mg/kg)混合配成碘油乳剂透视下缓慢注入行化疗性栓塞术。术后3周全麻下处死所有存活实验兔(12只),剖胸取肺组织,用4%甲醛溶液固定,取材后石蜡包埋,分别测量肿瘤最大直径并计算肿瘤体积,比较各组治疗后体积改变。同时,在C组标本中另外取材,冰冻切片下用苏丹Ⅲ染色监测治疗后肿瘤内部碘油沉积情况。结果A组转移瘤平均体积(130.56±9.41)mm3较经介入治疗后B组(69.47±10.00)mm3、C组(19.73±3.54)mm3左肺转移瘤平均体积明显大,而C组左肺转移瘤体积较B组小,差异具有统计学意义(P<0.05)。2只兔术中死亡,死亡兔肺转移瘤内均见碘油沉积。另外,化疗栓塞后3周C组转移瘤内仍然可见散在碘油沉积,部分碘油已进入肿瘤实质内。结论化疗性栓塞术治疗肺部转移瘤确实可行,有利于控制肺转移瘤。经过碘油脂质染色进一步证实肺动脉参与了转移性肺癌的血供,尤其是参与了早期肺内微小转移结节的供血。随肿瘤结节的不断增大,转移瘤的肺动脉血供也不断增多。Objective To investigate the feasibility and efficacy of pulmonary artery chemoembolization in experimental lung metastases, and to elucidate pulmonary arterial supply to metastases using lipiodol as a tracer. Methods 14 New Zealand white rabbits were selected to establish the experimental hematogenous pulmonary metastastic VX2 tumor models, and then randomly divided into 3 groups （group A, n = 4; group B, n = 4; group C, n = 6）. All rabbits were under general anesthesia to have exploration of femoral veins. Group A served as control was perfused with normal saline（5 ml, per rabbit）. Group B and C were assigned for experimentation and received anticancer drug perfusion of pharmorubicin（2 mg/kg） plus carboplatin （15 mg/kg）, and carboplatin（15 mg/kg）, respectively. And then simultaneously, uilateral pulmonary chemoembolization（UPCE） with lipiodal emulsion formed by mixing superlignified lipiodal 1 ml and pharmorubicin （2 mg/kg）was carried out by slow infusion under fluourscopic monitoring. The remained 12 survival rabbits were sacrificed 3 weeks later and then the removal of their trancheas and lungs as specimens was undertaken for pathologic examination. The tumors size was presented by its greatest diameter for calculating the volume change in comparison before and after treatment. Additional cryostal sections and Sudan 11I staining were performed for group C members. Results After the experimentation, the average volume of metastatic tumor in group A （130.56 ± 9.41 mm^3） was significantly larger than those in group B（69.47 ± 10.00 mm^3） and C（19.73 ± 3.54 mm^3）, respectively; but furthermore, the tumor volume of group C was lesser than that of group B with significant statistical difference （P 〈 0.05）. Lipiodal deposition appeared in the metastatic tumor of the 2 experimental rabbits died of pulmonary arterial infarction during the lipiodal emulsion infusion. On the other hand, the disseminated lipiodal depositions were found in the metastatic tumors of group C, 3

关 键 词：化疗性栓塞 肺部转移瘤 肺动脉 

分 类 号：R734.2[医药卫生—肿瘤]