微波消融联合索拉非尼治疗兔肝Vχ2原位种植瘤的研究  

The research of sorafenib in combination with microwave ablation on rabbit orthotopic Vχ2 liver tumor model

作　　者：孔文韬[1] 汤阳 张小龙 蔡浩 王文平 

机构地区：[1]南京大学医学院附属鼓楼医院超声诊断科,210003 [2]复旦大学附属中山医院超声科,上海200032 [3]复旦大学附属中山医院肝癌研究所,上海200032

出　　处：《中华实验外科杂志》2017年第10期1680-1683,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金（81371577）

摘　　要：目的探讨索拉非尼作为辅助性手段联合微波消融对兔肝脏Vχ2种植瘤的治疗价值。方法37只建模成功的实验兔被随机分为不全微波消融组（n＝11）、联合治疗组（n＝14）、对照组（n＝12）。微波功率设定为20 W，1 min，可获得大小约1 cm消融灶。联合治疗组同时以索拉非尼30 mg/kg灌胃，每日1次，其余两组生理盐水灌胃。肿瘤生长曲线根据治疗前后肿瘤的体积变化绘制。治疗效果的评估采用超声造影、磁共振以及免疫组织化学检查。定量资料的分析采用独立样本t检验与单因素方差分析，分类资料的分析采用χ2检验与Fisher精确检验，以P〈0.05为差异有统计学意义。结果微波组治疗后肿瘤生长加速，在治疗后3、7、14 d微波组肿瘤体积均大于对照组与联合治疗组（P＝0.007、0.001、0.001），而对照组与联合治疗组肿瘤的体积在治疗后3个时间点差异均无统计学意义（P＝0.381、0.069、0.328）；联合治疗组术后转移率低于微波组与对照组；超声造影显示联合治疗组多为短线状、环状低增强，且多位于病灶周边，而微波组多为团块状、网格状高增强，可从周边延伸至病灶内部。弥散加权成像（DWI）显示联合治疗组残癌表观扩散系数（ADC）大于对照组与微波组，差异有统计学意义（1.845±0.503比1.102±0.149，0.979±0.235）。免疫组织化学提示微波组微血管密度（MVD）大于对照组（18.20±2.30比12.63±6.88），而联合治疗组小于对照组（5.33±3.11比12.63±6.88），差异均有统计学意义。 结论不完全热消融后残癌生长加速，索拉非尼可在一定程度上抑制残癌的血管生成以及肿瘤活性。ObjectiveTo evaluate the value of sorafenib as an adjuvant therapy in combination with microwave （MW） ablation on rabbit Vχ2 liver tumor model. MethodsThirty-seven rabbits with orthotic Vχ2 liver tumors were randomly divided into MW group （n=11）, combination treatment group （n=14） and control group （n=12）. MW therapy was performed with an output power of 20 W for one minute, achieving a maxim ablation diameter of about 1 cm. Sorafenib was given with a dosage of 30 mg/kg per day, while saline were given to the control group and the MW group. Tumor growth-curve in each group was drawn according to tumor volumes before and after treatment. The therapeutic efficacy was evaluated by contrast enhanced ultrasound （CEUS）, magnetic resonance imaging （MRI）, pathological and immunohistochemical examinations. The independent samples t-test and One-way ANOVA test were used to analyze the quantitative data. Chi-square test and fisher exact test were used to analyze the classified data. Two-tailed P〈0.05 was considered statistically significant. ResultsThe tumor growth was accelerated in MW group compared with control group and combination treatment group. The mean tumor volume in MW group at 3 d, 7 d and 14 d was significantly larger than those in two other groups （P=0.007, 0.001, 0.001）, whereas no significant differences were found in tumor volume between control group and combination treatment group （P=0.381, 0.069, 0.328）. A low metastases rate was shown in combination treatment group compared with other two groups. In combination treatment group, CEUS showed short rod-like and rim-like hypo-enhancement mainly detected in the periphery of lesion. However, conglomerate and latticed hyper-enhancement were the most patterns in MW group, with enhanced areas both in peripheral and internal of tumors. The apparent diffusion coefficient （ADC） value on diffused weighted image （DWI） was higher compared with that of the control and MW group, with statistical significance （1.845±0.503

关 键 词：微波消融 索拉非尼 肝脏Vχ2原位种植瘤 超声造影 微血管密度 表观扩散系数 

分 类 号：R735.7[医药卫生—肿瘤]