聚合白蛋白和胶体^(32)P瘤内注射治疗肝癌的动物实验与临床应用  

Intratumoral injection of macroaggragated albumin and colloidal ^(32)P for the treatment of hepatocellular carcinoma

作　　者：刘吉勇[1] 杨崇美[1] 邵文博[2] 韩建奎[2] 

机构地区：[1]山东省立医院消化内科,250021 [2]山东医科大学核医学教研室

出　　处：《中华肝脏病杂志》2001年第5期309-311,共3页Chinese Journal of Hepatology

基　　金：山东省卫生厅科研经费资助(96046)

摘　　要：目的 研究单纯注射胶体32P和先注入聚合白蛋白（MAA），再注射胶体32P两种不同给药方法的32P体内分布情况，探讨瘤内注射MAA和胶体32P治疗肝癌的疗效与副作用。 方法 在Bal b/c 小鼠右侧胸前皮下接种H22肝癌细胞，10d后长出直径约1cm的肿瘤，将其随机分为2组，第1组只注射胶体32P 1.85MBq；第2组先注入1×105颗粒MAA，再注入胶体32P 1.85MBq，注射后30min、24h、48h、8d和16d分别测定肿瘤组织、外周血液和心、肝、脾、肾、骨髓的放射性；第16天和1个月时对肿瘤组织作病理切片，观察治疗效果。临床上B超引导下将MAA和胶体32P依次瘤内注射治疗肝癌30例，观察治疗前后临床症状、肿块大小、AFP水平、心肝肾功能、外周血象和免疫指标。 结果 胶体32P内照射可使肿瘤组织坏死、纤维化。预先注射MAA，MAA可以有效阻止32P的全身扩散，使胶体32P长时间滞留在肿瘤内。临床应用发现该方法可使肿块缩小，平均缩小率53.25%，血清AFP水平下降，临床症状改善，1、2、3年生存率分别为90%、76.67%、43.33%，无心、肝、肾损害和骨髓抑制等副作用。 结论 瘤内注射MAA和胶体32P是一种简单、安全、有效的治疗肝癌的新方法。Objective To study the tumor deposition and systemic distribution of colloidal 32P in single colloidal 32P injection and macroaggragated albumin (MAA) injection followed by colloidal 32P and to evaluate their clinical effects and side effects for the treatment of hepatocellular carcinoma. Methods H22 hepatocellular cancer cells were inoculated subcutaneously in the right fore leg of Balb/c mice. When the tumors reached to 1.0cm in diameter about 10 days postinjection, the mice were divided into two groups randomly. In the first group, the tumors were only injected with 1.85 MBq of colloidal 32P; while in the second group, with 1×105 particles of MAA followed by 1.85 MBq of colloidal 32P. The radioactivity in the tumor, blood, heart, liver, kidney, spleen, and bone of each animal was determined at 30min, 24h, 48h, 8d, and 16d postinjection. Histopathology of tumors was observed at 16d and 1 month postinjection. The ultrasound-guided intratumoral injection of MAA and colloidal 32P was performed on 30 patients with hepatocellular cancer. The evaluation of efficacy and side effects was made on the basis of clinical manifestations, histopathological changes, variations in tumor size, serum AFP, the functions of heart, liver, kidney, blood routine, and immune functions before and after the treatment. Results Intratumoral injection of colloidal 32P resulted in necrosis and fibrosis of the tumor cells. Pretreatment with MAA before administration of colloidal 32P effectively decreased the diffusion of colloidal 32P from the tumor to blood, and led to retention of colloidal 32P in the tumor for a longer time. After treatment, a significant shrinkage of the tumor size was seen in all cases with the average shrinkage rate of 53.25%. Serum AFP values decreased remarkably. Clinical symptoms alleviated. The survival rate of 1, 2, and 3 years was 90%, 76.67%, 43.33%. No side effect was found. Conclusions Intratumoral injection of MAA and colloidal 32P is a simple, safe, and effective alternative for the treatment of

关 键 词：肝细胞癌 同位素 聚合白蛋白 瘤内注射 胶体^32P 动物实验 

分 类 号：R735.7[医药卫生—肿瘤] R73－36[医药卫生—临床医学]