大鼠ALPPS术后残肝再生与Wnt2蛋白表达关系的研究  

Study on the relationship between remnant liver regeneration and Wnt2 protein expression in rats after ALPPS

作　　者：刘伟伟[1] 余锋[2] 刘洪[2] 李福利[2] 柏杨[2] 罗昆仑[1,2] 

机构地区：[1]安徽医科大学无锡临床学院肝胆外科,无锡214044 [2]中国人民解放军第一〇一医院肝胆外科,无锡214044

出　　处：《安徽医科大学学报》2017年第9期1331-1335,共5页Acta Universitatis Medicinalis Anhui

基　　金：南京军区医学科技创新课题重点资助项目(编号:14D05)

摘　　要：目的探讨大鼠联合肝脏分割和门静脉结扎分阶段肝切除术(ALPPS)后残余肝再生Wnt2蛋白的表达变化,进一步了解肝再生过程中的分子机制。方法选取200~240g健康SD雄性大鼠40只,随机分为ALPPS组和假手术(Sham)组;Sham组仅游离出门静脉各分支,不结扎即关腹;ALPPS组行大鼠肝左外叶、左中叶、右叶门静脉分支结扎,切除尾状叶,保留肝右中叶分支,并行肝中叶实质离断。分别于术后1、2、4、7 d处死5只大鼠,称取大鼠肝右中叶重量,计算肝再生率;光学显微镜下观察肝右中叶细胞的形态学变化,免疫组化法检测肝右中叶Ki-67和Wnt2蛋白表达变化,并进行统计分析。结果 (1)ALPPS术后保留侧肝脏开始再生,第2天肝再生率升高最快,随后肝再生率升高速度逐渐降低,第7天与Sham组相比肝再生率升高速度两者相近;(2)ALPPS术后Ki-67与Sham组比较,第1天开始升高,第2天达到最高,此后逐渐降低,第7天有少量阳性细胞,与Sham组相比差异无统计学意义;(3)Wnt2阳性表达主要在中央静脉周围,可能与肝干细胞的产生相关;与Sham组相比,肝右中叶Wnt2蛋白在ALPPS术后第1天即开始升高,第2天达到最高,然后逐渐降低,第7天时仅有少量表达,与Sham组相比差异无统计学意义;(4)大鼠肝脏ALPPS术后Wnt2的表达与术后Ki-67的表达呈正相关性。结论 Wnt2在ALPPS术后肝脏再生及肝干细胞表达过程中起重要的调控作用。Objective To evaluate expression of WNT2 and its relationship with remnant liver regeneration afterassociating liver partition and portal vein ligation for staged hepatectomy （ALPPS） in rats and the underling mecha- nisms in liver regeneration. Methods Forty healthy male Sprague-Dawley （SD） rats （200 -240 g） were randomly divided two groups：ALPPS group , Sham group. The Sham group only freed vein branches without ligation and closed its abdomen. The ALPPS group consisted of 70% portal vein ligation（ occluding the left middle ,left lateral, and right lobes） and partial （10%） hepatectomy（ caudate lobe）, parenchymal transaction （median lobe）, the right middle lobe was preserved to regenerate. Five rats were sacrificed on day 1,2,4 and 7 in each group after operation to observe the weight of the right median lobe. The morphological changed of the right middle lobe liver lobes were observed by microscope. The expression of Wnt2 and Ki-67 of the right middle lobe liver lobes were studied with immunohistochemistry. The results were analyzed by medical statistics methods. Results ① Remnant liver regen- erate after ALPPS in rats,liver regeneration increased the fastest at the second day, then the speed of liver regener- ation rate decreased gradually, there was no statistical significance in ALPPS group compared with Sham at the sev- enth day; ② Compared with the Sham group, the Ki-67 after surgery began to increase, it reached the maximum at the second day, then decreased gradually, there were a few positive cells at the seventh day and no statistical sig- nificance; ③ The positive expression of Wnt2 was mainly around the central vein, it may be associated with the generation of liver stem cells. Compared with Sham group, Wnt2 in remnant liver began to rise after ALPPS, reached the highest at the second day, and then decreased gradually, only a small amount of expression at the sev- enth day and there was no statistical significance; ④The expression of Wnt2 and Ki-67 had a positive c

关 键 词：肝再生 ALPPS Wnt2 

分 类 号：R735.7[医药卫生—肿瘤]