VX2兔肝癌Hepasphere微球联合Avastin栓塞前后的CT灌注成像分析  

作　　者：杜玉清[1] 顾文权[1] 孙学栋[1] 王彬[1] 

机构地区：[1]上海市浦东新区浦南医院,上海200125

出　　处：《世界中医药》2016年第B03期1174-1175,共2页World Chinese Medicine

基　　金：上海市卫生局资助课题（20114176）

摘　　要：目的探讨应用索Hepasphere微球联合Avastin栓塞治疗兔VX2肝癌的疗效，分析栓塞前后肿块周边的cT灌注参数与微血密度（MVD）、血管内皮生长因子（VEGF）表达的相关性，探索cT灌注成像监测肿瘤生长的可行性。方法：建立30只新两兰大白兔VX2肝癌模型，随机分为三组，A组：Hepasphere微球栓塞10只，B组：Hepasphere微球＋Avastin栓塞lO只，C组：生理盐水10只，了二治疗前、治疗后14 d行cT灌注成像，获取肝动脉灌注量（HAP）、门静脉灌注量（PVP）及肝动脉灌注指数（HAPI），处死实验兔，采用免疫组化检测MVD、VEGF的表达。结果：栓塞治疗前3组肿瘤周边cT灌注参数HAP、PVP、ftAPI值差异无统计学意义（P〉0．05），栓塞后c组HAP、HAPI增加，PVP降低；A、B两组HAP、HAPI均有明显降低，B组较A组降低明显，PVP均有增加；B组MVD、VEGF计数较A、C组减低（P〈0．05）。肿瘤VEGF与MVD呈显著正相关（P〈0．05），三组中HAP、PVP、HAPl分别与MvD、VEGF呈正相关（P〈0．05）。结论：cT灌注成像结合MVD和VEGF表达，能较好地评价兔VX2肝癌模型的血流动力学变化；Hepasphere微球联合Avastin栓塞治疗兔VX2肝癌与单纯Hepasphere微球栓塞相比，可明显降低VEGF的表达，显著地抑制治疗后肿瘤新生血管的形成。Objective To study the CT perfusion parameter change and histology of rabbit liver VX2 tumor before and after the application ofTAE and Avastin,it was supposed to explore the feasibility of CT perfusion imaging in monitoring of the growth of liver tumor,and to provideexperimental basis for evaluation the effect of TAE and Avastin inhibiting tumor angiogenesis.Methods：30 rabbits implanted with liver VX2tumors were randomly divided into 3 groups,with 10 rabbits in each group. All rabbits were demonstrated with liver neoplasmas by MSCT andtreated with transhepatic arterial embolization under the open laparotomy.Group A was embolized with hepasphere;Group B was administratedwith 5 mg Avastin and hepasphere;Group C was given 3 ml saline.The various perfusion parameters（HAP,PVP,HAPI）were measured in the edgeof tumor area and the expression of MVD and VEGF were determined with immunohistochemistry on the 14th day after treatment.All parameterthus gained were compared among the 3 groups.Results：The difference in perfusion parameters （HAP,PVP and HAPI）among three groups was ofno statistical significance（P〉0.05）before embolization,It was demonstrated that the increased HAP,HAPI and the decreased PVP in group C afterthe treatment.Although the perfusion parameters in group B were significantly lower than that in group A, the decreased HAP,HAPI andincreased PVP was demonstrated in group A and B;MVD and VEGF in group B were obviously lower than these in group A and group C.Apositive correlation existed between VEGF and MVD in all three groups（P〈0.05）.HAP,PVP and HAPI showed a positive correlation with VEGFand MVD （P〈0.05）in 3 groups.Conclusion：The CT peffusion imaging had advantages in the changes of hemodynamics of the rabbit model ofVX2 liver tumor if combination with the research of MVD and VEGF,transarterial embolization with Avastin combined hepasphere caneffectively inhibit the growth of hepatic tumor and reduce the expression level of VEGF and the formation of the tumor vessels than withH

关 键 词：肝肿瘤 微球 AVASTIN 栓塞治疗 CT灌注 

分 类 号：R735[医药卫生—肿瘤]