不同粒径ContourSe微球栓塞肝动脉治疗兔VX-2移植性肝癌的实验研究  

An Experimental Study of Hepatic Arterial Embolization with Different ContourSe Microspheres on VX-2 Transplanted Liver Tumor in Rabbits

作　　者：杨积慧[1] 颜志平[2] 王建华[2] 罗剑钧[2] 陈颐[2] 王平[2] 刘清欣[2] 王永刚[2] 陈颖[1,3] 

机构地区：[1]上海交通大学附属第一人民医院放射科,上海200080 [2]复旦大学附属中山医院放射科,上海200032 [3]上海交通大学附属第一人民医院肿瘤科,上海200080

出　　处：《中国临床医学》2009年第1期83-86,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:研究不同粒径ContourSe微球对兔VX-2移植性肝癌的栓塞作用及对正常肝组织的影响,初步确定ContourSe微球肝动脉栓塞治疗肝癌的最佳粒径范围。方法:经剖腹途径将VX-2瘤粒悬液直接注入兔肝实质内建立兔VX-2移植性肝癌模型,共30只兔。用不同粒径的ContourSe微球对兔VX-2移植性肝癌模型行肝动脉栓塞治疗,根据使用ContourSe微球粒径的不同分为5组,第1组(n=6):注入1mL0.9%氯化钠液,作为对照组;第2组(n=6):用ContourSe微球(100～300μm)栓塞;第3组(n=6):用ContourSe微球(300～500μm)栓塞;第4组(n=6):用ContourSe微球(500～700μm)栓塞;第5组(n=6):用ContourSe微球(700～900μm)栓塞。栓塞术前行CT扫描了解兔肝肿瘤大小,栓塞术后定期处死作肝脏大体标本观察和组织学检查,了解肿瘤大小及坏死程度、正常肝组织损害情况和腹腔脏器并发症。结果:兔肝肿瘤种植成功率达100%。各组兔肝肿瘤生长率的平均值分别为,第1组:2.5450;第2组:1.3711;第3组:1.5263;第4组:1.9431;第5组:2.1699。第2组与第3组比较无明显差异(P=0.195),此2组与其余3组比较均有显著差异(P<0.001)。第2组及第3组肿瘤坏死均以重度坏死为主,尤其第2组坏死率最高。第2组兔肝可见多发灶状坏死,汇管区可见胆管壁坏死,肝纤维结缔组织间隔亦可见坏死溶解改变。结论:(1)小于500μm的ContourSe微球能较有效地阻断肿瘤血供,抑制肿瘤生长;(2)100～300μm ContourSe微球组虽然肿瘤坏死最明显,但可以引起正常肝组织胆道及肝内结缔组织坏死,临床使用须在超选择插管的前提下谨慎使用;(3)300～500μm ContourSe微球最适于临床肝肿瘤的栓塞治疗。Objective：To study the embolic effect of different ContourSe microspheres on VX 2 transplanted liver tumor and normal liver tissue in rabbits and to determine the optimal diameter range of ContourSe mierospheres for liver tumor embolization. Methods： Thirty models of VX-2 transplanted liver tumor in rabbits were established by injecting suspension of VX-2 tumor tissue particles into rabbits liver via laparotomic route. Hepatic arterial embolization was performed by catheterizing via femoral artery（14 days after implantation）. The models were divided into five groups according to different ContourSe microspheres, group1 （n = 6） ：normal saline as control, group2（n = 6） ：ContourSe microspheres（ 100-300 μm）, group3（ n = 6） ,ContourSe microspheres（300-500 μm）, group4 （ n = 6 ） ： ContourSe microspheres （ 500-700μm）, group5 （ n = 6） ： ContourSe microspheres（700-900 μm）. The tumor volume was determined by CT 1 day before therapy and by pathology 7 days after therapy. Results：The success rate of tumor implantation reached to 100%. The mean tumor growth rate were 2. 5450,1. 3711, 1. 5263, 1. 9431 and 2. 1699 in groupl.2,3,4,5 and respectively. A favorable outcome was observed in group2 and group3, tumor growth rate was significantly （P〈0. 001） lowered , necrosis much more extensive than those of the other 3 groups. Multiple focal necrosis of liver, damage of bile duct and liver fiber connective tissue were observed in group2. Conclusion：The growth of VX-2 liver tumor could be effectively prevented by utilizing ContourSe microspheres smaller than 500 μm. The ContourSe microspheres（100-300 μm） should be cautiously used in superselective embolization because it could cause damage of bile duct and liver fiber connective tissue. ContourSe mierospheres（300-500 μm） are most suitable for embolization of liver tumor.

关 键 词：ContourSe微球 VX-2肝癌 动物模型 兔 

分 类 号：R815[医药卫生—放射医学]