经导管动脉化疗栓塞联合索拉非尼治疗兔VX2肝种植瘤MSCT灌注与病理及免疫组化的对照研究  

Comparative study on MSCT perfusion imaging, pathology and immunohistochemical in rabhit VX2 liver tumor treated with combinaion therapy of transcatheter arterial chemoembolization and sorafenib

作　　者：吴越[1] 杨本强[1] 刘昕[2] 刘文源[1] 李子浩[1] 

机构地区：[1]沈阳军区总医院,放射诊断科 [2]沈阳军区总医院,整形外科,辽宁沈阳110016

出　　处：《实用放射学杂志》2012年第6期947-953,共7页Journal of Practical Radiology

摘　　要：目的探讨应用抑制肿瘤血管生成药物以进一步提高经导管动脉化疗栓塞（TACE）疗效疗法的可行性。方法30只新西兰大白兔建立兔VX2肝种植瘤模型，将模型兔随机分成A、B、C3组，每组10只。A组为生理盐水对照组，B组为TACE治疗组，C组为TACE＋索托非尼联合治疗组。VX2肝种植瘤模型兔于治疗前（治疗时间选择接种VX2肿瘤组织2周）及治疗后第1、2、3周行CT平扫观察肿瘤生长情况。于治疗前与治疗后第3周行CT灌注扫描并记录肿瘤的肝血流量（HBF）、肝血容积（HBV）、平均通过时间（MTT）、毛细血管表面通透性（PS）和肝动脉分数（HAF）等参数值。然后处死实验兔，进行病理以及血管内皮生长因子（vascularendothelialgrowthfactor．VEGF）与CD34免疫组织化学染色。检测VEGF与CD34的表达情况。结果治疗后不同时期各组两两比较肿瘤大小与肿瘤乍长率均有显著性差异（P〈0．01）。治疗前后B组、C组的HAF、HBF值差异有统计学意义（P〈0．01）。不同肿瘤组间VEGF表达及MVD计数差异有统计学意义（P〈0．01）。结论索拉非尼与TACE联合应用能够抑制肿瘤生长．并提高VX2瘤治疗的疗效。Objective To study the feasibility of treatment for rabbit VX2 liver tumor with combination of transcathether arterial chemembolixation （TACE） and sorafenib. Methods 30 liver VX2 tumor modles of New Zealand white rabbits were established. 30 modles were randomly divided into three groups based on therapeutic stratigies： group A with 0.9 % sodium chloride, group B with TACE; group C with TACE plus sorafenib, 10 modles in each group. MSCT scans were performed at 1st week to 3th week after therapy in order to measure the volume changes of tumors. Tumor growing situations were observed by MSCTat pre-and post ther- apy （at the 1st, 2ndand 3th week）. MSCTperfusionparametersincluding hepatic blood flow （HBF）, hepatic blood volume（HBV） mean transit time （MTT）. permeability surface（PS） and hepatic arterial fraction （HAF） in the tumor regions were measured at pre- therapy and the 3th week of post therapy. All the rabbits with VX2 tumor were executed for routine pathological examination and vascular endothelial growth factor（VEGF） and CD34 staining after 3 weeks of treatment. Expression of VEGF and CD3.i was detec ted, and the percentage of positive tumor ceils and microvessel density （MVD） were calculated and compared at high power field （400）〈 magnification）. Results The size and growth rate of tumors were significant different between different groups （P〈0.01）. The statistical analysis showed significant difference in HAF and HBF of liver tumors between group B and C. Expression of VEGF and CD34 were significant different between different groups （P〈0. 01 ）. Conclusion Sorafenih combined with TACE in treating VX2 tumors can inhihit tumor growth and improve the therapeutic effect.

关 键 词：体层摄影术 X线计算机 VX2肿瘤 实验 索拉非尼 

分 类 号：R814.42[医药卫生—影像医学与核医学] R73-354[医药卫生—放射医学]