经肝动脉化疗栓塞术联合射频消融治疗兔肝VX2肿瘤的效果分析

李浩; 段旭华; 韩新巍; 任建庄; 李凤尧; 邝东林; 李方正

doi:10.3969/j.issn.1001-5256.2018.04.017

经肝动脉化疗栓塞术联合射频消融治疗兔肝VX2肿瘤的效果分析

DOI: 10.3969/j.issn.1001-5256.2018.04.017

郑州大学第一附属医院介入科

基金项目:

国家自然科学青年基金资助项目(81401494)；河南省科医学科技计划攻关项目(201403059)；

详细信息

中图分类号: R735.7
计量
- 文章访问数: 2204
- HTML全文浏览量: 13
- PDF下载量: 404
- 被引次数: 0
出版历程
- 出版日期: 2018-04-20

Clinical effect of transarterial chemoembolization combined with radiofrequency ablation in treatment of rabbit VX2 liver tumors

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University

Research funding:

摘要

摘要: 目的观察经肝动脉化疗栓塞术（TACE）联合射频消融（RFA）以及单独应用对兔肝VX2肿瘤的效果及病理学改变。方法将18只建模成功的荷瘤兔平均分为3组,每组6只:TACE+RFA治疗组（TACE后15 min采用RFA治疗）,单独行TACE治疗组和单独行RFA治疗组。术后7 d处死实验兔,比较肿瘤区凝固性坏死区或出血性性梗死区的最大切面积,对比典型的病理切片。计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验。结果 RFA组中1只实验兔死于术中气胸;术后2 d TACE+RFA组中1只实验兔死于大面积肝坏死。16只实验兔存活至观察点结束,实验成功率为88.9%（16/18）。TACE+RFA组中的凝固性坏死最大长径、短径和肿瘤细胞坏死率与其他2组比较,差异均有统计学意义（P值均<0.05）。病理分析显示,TACE+RFA组和其他组相比具有更多的血管栓塞及坏死区、较少的岛屿状存活肿瘤细胞群。结论 TACE+RFA较单独应用RFA和TACE能够收获更好的肿瘤毁损效果。
- 癌,肝细胞 /
- 化学栓塞,治疗性 /
- 导管消融术 /
- 治疗结果
Abstract: Objective To investigate the clinical effect of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) (TACE + RFA) versus RFA or TACE alone in the treatment of rabbit VX2 hepatic tumors and related pathological changes.Methods The rabbits were sacrificed at 7 days after surgery, and the maximal diameter of coagulative necrotic zone or hemorrhagic infarct zone was compared, as well as typical pathological sections.An analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups.Results One rabbit in the RFA group died of pneumothorax and one in the TACE + RFA group died of extensive liver necrosis at 2 days after surgery.The other 16 rabbits survived to the end of observation, resulting in a success rate of 88.9% (16/18) .There were significant differences between the TACE + RFA group and the other two groups in the maximal long and short diameters of coagulative necrotic zone and tumor cell necrosis rate (all P < 0.05) .The pathological analysis revealed greater vascular thrombosis, larger necrotic zone, and fewer clusters of viable tumor cells in the TACE + RFA group, compared with the other groups.Conclusion TACE + RFA has a better effect in tumor destruction than RFA or TACE alone.
- carcinoma, hepatocellular /
- chemoembolization, therapeutic /
- catheter ablation /
- treatment outcome

HTML全文

参考文献(18)

[1]HAN K, KIM JH.Transarterial chemoembolization in hepatocellular carcinoma treatment:Barcelona clinic liver cancer staging system[J].World J Gastroenterol, 2015, 21 (36) :10327-10335.

[2]GAO HJ, CHEN MS.Radiofrequency ablation for the treatment of hepatocellular carcinoma[J].J Clin Hepatol, 2012, 28 (4) :249-252. (in Chinese) 高恒军, 陈敏山.原发性肝癌的射频消融治疗[J].临床肝胆病杂志, 2012, 28 (4) :249-252.

[3]LI HL, JI WB, ZHAO R, et al.Poor prognosis for hepatocellular carcinoma with transarterial chemoembolization pre-transplantation:retrospective analysis[J].World J Gastroenterol, 2015, 21 (12) :3599-3606.

[4]SPREAFICO C, CASCELLA T, FACCIORUSSO A, et al.Transarterial chemoembolization for hepatocellular carcinoma with a new generation of beads:clinical-radiological outcomes and safety profile[J].Cardiovasc Intervent Radiol, 2015, 38 (1) :129-134.

[5]MURAKAMI T, ISHIMARU H, SAKAMOTO I, et al.Percutaneous radiofrequency ablation and transcatheter arterial chemoembolization for hypervascular hepatocellular carcinoma:rate and risk factors for local recurrence[J].Cardiovasc Intervent Radiol, 2007, 30 (4) :696-704.

[6]IKEDA K, OSAKI Y, NAKANISHI H, et al.Recent progress in radiofrequency ablation therapy for hepatocellular carcinoma[J].Oncology, 2014, 87 (Suppl 1) :73-77.

[7]LYU TS, ZOU YH, WANG J, et al.Current status of transcatheter arterial chemoembolization combined with radiofrequency ablation in treatment of primary liver cancer[J].J Clin Hepatol, 2016, 32 (1) :49-55. (in Chinese) 吕天石, 邹英华, 王健, 等.经肝动脉化疗栓塞术联合射频消融治疗原发性肝癌的现状[J].临床肝胆病杂志, 2016, 32 (1) :49-55.

[8]SONG J, WANG Y, MA K, et al.Laparoscopic hepatectomy versus radiofrequency ablation for minimally invasive treatment of single, small hepatocellular carcinomas[J].Surg Endosc, 2016, 30 (10) :4249-4257.

[9]BIMONTE S, LEONGITO M, PICCIRILLO M, et al.Radio-frequency ablation-based studies on VX2rabbit models for HCC treatment[J].Infect Agent Cancer, 2016, 11:38.

[10]DUAN XH, LI TF, ZHOU GF, et al.Transcatheter arterial embolization combined with radiofrequency ablation activates CD8+T-cell infiltration surrounding residual tumors in the rabbit VX2 liver tumors[J].Onco Targets Ther, 2016, 9:2835-2844.

[11]ROSSI S, GARBAGNATI F, LENCIONI R, et al.Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply[J].Radiology, 2000, 217 (1) :119-126.

[12]MOSTAFA EM, GANGULI S, FAINTUCH S, et al.Optimal strategies for combining transcatheter arterial chemoembolization and radiofrequency ablation in rabbit VX2 hepatic tumors[J].J Vasc Interv Radiol, 2008, 19 (12) :1740-1748.

[13]IEZZI R, POMPILI M, POSA A, et al.Combined locoregional treatment of patients with hepatocellular carcinoma:state of the art[J].World J Gastroenterol, 2016, 22 (6) :1935-1942.

[14]WU HP, LIANG HM, ZHENG CS, et al.Lipiodol flowing into portal vein after hepatic artery embolization:the influential factors and its clinical significance[J].J Clin Radiol, 2005, 24 (5) :429-433. (in Chinese) 吴汉平, 梁惠民, 郑传胜, 等.肝动脉栓塞碘油进入门静脉的相关因素及其临床意义[J].临床放射学杂志, 2005, 24 (5) :429-433.

[15]LENCIONI R, CROCETTI L, PETRUZZI P, et al.Doxorubicineluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma:a pilot clinical study[J].J Hepatol, 2008, 49 (2) :217-222.

[16]KONG G, ANYARAMBHATLA G, PETROS WP, et al.Efficacy of liposomes and hyperthermia in a human tumor xenograft model:importance of triggered drug release[J].Cancer Res, 2000, 60 (24) :6950-6957.

[17]HIGUCHI T, KIKUCHI M, OKAZAKI M.Hepatocellular carcinoma after transcatheter hepatic arterial embolization.A histopathologic study of 84 resected cases[J].Cancer, 1994, 73 (9) :2259-2267.

[18]DUDAR TE, JAIN RK.Differential response of normal and tumor microcirculation to hyperthermia[J].Cancer Res, 1984, 44 (2) :605-612.

施引文献

资源附件(0)

访问统计