中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2010年
3期
316-322
,共7页
牛焕章%顾宁%余辉%邓钢%郭金和%何仕诚%陈晟%马明%徐睿智%李国昭%滕皋军
牛煥章%顧寧%餘輝%鄧鋼%郭金和%何仕誠%陳晟%馬明%徐睿智%李國昭%滕皋軍
우환장%고저%여휘%산강%곽금화%하사성%진성%마명%서예지%리국소%등고군
肝肿瘤,实验性%纳米粒子%化学栓塞,治疗性%模型,动物
肝腫瘤,實驗性%納米粒子%化學栓塞,治療性%模型,動物
간종류,실험성%납미입자%화학전새,치료성%모형,동물
Liver neoplasms,experimental%Nanoparticles%Chemoembolization,therapeutic%Models,animal
目的 探讨碘油磁液经肝动脉栓塞热疗术对荷瘤兔肝、肾功能的影响及其疗效.方法 VX2兔肝癌模型32只,数字表法随机等分成4组:碘油磁液栓塞热疗组(A组)、碘油磁液栓塞组(B组)、单纯碘油栓塞组(C组)、对照组(D组).A、B两组实验兔经肝动脉注入碘油磁液0.5～0.8 ml栓塞病灶,C组实验兔仅用碘油栓塞.栓塞后仅A组实验兔在交变磁场下诱导热疗.实验兔分别于栓塞或栓塞热疗术前1 d和术后1、7、14 d经耳缘静脉取血,行肝、肾功能检查.肝功能指标选取丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST),肾功能指标选取血清尿素氮(BUN)和血清肌酐(Cr).栓塞术前、术后即刻、术后7、14 d行CT扫描并随访,观察碘油磁液或碘油在瘤内沉积分布情况并分别测量肿瘤大小.术后14 d处死实验兔,完整切取肝脏、脾、肾和肺,作病理检查.各组测量数据以重复测量方差分析进行统计学分析.结果 A组实验兔术前1 d和术后1、7、14 d ALT分别为(43.9±19.0)、(795.1±327.1)、(67.0±9.3)、(41.9±10.8)U/L,AST分别为(50.2±13.6)、(1011.2±655.9)、(62.4±24.1)、(51.6±7.9)U/L;B组ALT分别为(45.0±19.1)、(580.8±160.4)、(67.2±31.0)、(47.6±7.8)U/L,AST分另U为(52.9±20.3)、(735.2±186.1)、(57.9±24.8)、(50.9±9.8)U/L;C组ALT分别为(47.4±14.6)、(558.5±167.8)、(63.5±21.9)、(48.0.±9.3)U/L,AST分别为(51.8±9.5)、(752.5±112.0)、(56.5 ±20.6)、(51.4±8.6)U/L;术后1 dALT和AST较术前和D组明显升高(P值均<0.01),术后7、14 d所测值与术前比较差异无统计学意义.栓塞术前后4组实验兔BUN和Cr值组间和组内比较,差异均无统计学意义.术后7 d CT示A、B、C 3组瘤区碘油磁液和碘油沉积分布与栓塞或栓塞热疗前相比无明显变化.术后14 d CT示A组瘤区碘油磁液沉积更集中、密实,B、C两组共5例肿瘤瘤周碘油磁液或碘油移位、部分消失.术后14 d,A组肿瘤体积[(6.1±0.6)cm~3]较术前[(7.8±1.4)cm~3]平均缩小约21.7%(F=17.56,P<0.01),而术前B、C两组肿瘤体积分别为(7.9±1.1)、(7.8±0.9)cm~3,治疗后14 d分别为(9.1±0.8)、(9.3±1.0)cm~3,较术前平均增大16.2%、18.9%(F值分别为25.23、55.50,P值均<0.01).病理检查,栓塞14 d后,A组肿瘤坏死均达80%以上,B、C两组肿瘤坏死约30%~50%.结论 碘油磁液对兔VX2肝癌行选择性肝动脉栓塞热疗是安全有效的,具有可行性.
目的 探討碘油磁液經肝動脈栓塞熱療術對荷瘤兔肝、腎功能的影響及其療效.方法 VX2兔肝癌模型32隻,數字錶法隨機等分成4組:碘油磁液栓塞熱療組(A組)、碘油磁液栓塞組(B組)、單純碘油栓塞組(C組)、對照組(D組).A、B兩組實驗兔經肝動脈註入碘油磁液0.5～0.8 ml栓塞病竈,C組實驗兔僅用碘油栓塞.栓塞後僅A組實驗兔在交變磁場下誘導熱療.實驗兔分彆于栓塞或栓塞熱療術前1 d和術後1、7、14 d經耳緣靜脈取血,行肝、腎功能檢查.肝功能指標選取丙氨痠轉氨酶(ALT)和天鼕氨痠轉氨酶(AST),腎功能指標選取血清尿素氮(BUN)和血清肌酐(Cr).栓塞術前、術後即刻、術後7、14 d行CT掃描併隨訪,觀察碘油磁液或碘油在瘤內沉積分佈情況併分彆測量腫瘤大小.術後14 d處死實驗兔,完整切取肝髒、脾、腎和肺,作病理檢查.各組測量數據以重複測量方差分析進行統計學分析.結果 A組實驗兔術前1 d和術後1、7、14 d ALT分彆為(43.9±19.0)、(795.1±327.1)、(67.0±9.3)、(41.9±10.8)U/L,AST分彆為(50.2±13.6)、(1011.2±655.9)、(62.4±24.1)、(51.6±7.9)U/L;B組ALT分彆為(45.0±19.1)、(580.8±160.4)、(67.2±31.0)、(47.6±7.8)U/L,AST分另U為(52.9±20.3)、(735.2±186.1)、(57.9±24.8)、(50.9±9.8)U/L;C組ALT分彆為(47.4±14.6)、(558.5±167.8)、(63.5±21.9)、(48.0.±9.3)U/L,AST分彆為(51.8±9.5)、(752.5±112.0)、(56.5 ±20.6)、(51.4±8.6)U/L;術後1 dALT和AST較術前和D組明顯升高(P值均<0.01),術後7、14 d所測值與術前比較差異無統計學意義.栓塞術前後4組實驗兔BUN和Cr值組間和組內比較,差異均無統計學意義.術後7 d CT示A、B、C 3組瘤區碘油磁液和碘油沉積分佈與栓塞或栓塞熱療前相比無明顯變化.術後14 d CT示A組瘤區碘油磁液沉積更集中、密實,B、C兩組共5例腫瘤瘤週碘油磁液或碘油移位、部分消失.術後14 d,A組腫瘤體積[(6.1±0.6)cm~3]較術前[(7.8±1.4)cm~3]平均縮小約21.7%(F=17.56,P<0.01),而術前B、C兩組腫瘤體積分彆為(7.9±1.1)、(7.8±0.9)cm~3,治療後14 d分彆為(9.1±0.8)、(9.3±1.0)cm~3,較術前平均增大16.2%、18.9%(F值分彆為25.23、55.50,P值均<0.01).病理檢查,栓塞14 d後,A組腫瘤壞死均達80%以上,B、C兩組腫瘤壞死約30%~50%.結論 碘油磁液對兔VX2肝癌行選擇性肝動脈栓塞熱療是安全有效的,具有可行性.
목적 탐토전유자액경간동맥전새열료술대하류토간、신공능적영향급기료효.방법 VX2토간암모형32지,수자표법수궤등분성4조:전유자액전새열료조(A조)、전유자액전새조(B조)、단순전유전새조(C조)、대조조(D조).A、B량조실험토경간동맥주입전유자액0.5～0.8 ml전새병조,C조실험토부용전유전새.전새후부A조실험토재교변자장하유도열료.실험토분별우전새혹전새열료술전1 d화술후1、7、14 d경이연정맥취혈,행간、신공능검사.간공능지표선취병안산전안매(ALT)화천동안산전안매(AST),신공능지표선취혈청뇨소담(BUN)화혈청기항(Cr).전새술전、술후즉각、술후7、14 d행CT소묘병수방,관찰전유자액혹전유재류내침적분포정황병분별측량종류대소.술후14 d처사실험토,완정절취간장、비、신화폐,작병리검사.각조측량수거이중복측량방차분석진행통계학분석.결과 A조실험토술전1 d화술후1、7、14 d ALT분별위(43.9±19.0)、(795.1±327.1)、(67.0±9.3)、(41.9±10.8)U/L,AST분별위(50.2±13.6)、(1011.2±655.9)、(62.4±24.1)、(51.6±7.9)U/L;B조ALT분별위(45.0±19.1)、(580.8±160.4)、(67.2±31.0)、(47.6±7.8)U/L,AST분령U위(52.9±20.3)、(735.2±186.1)、(57.9±24.8)、(50.9±9.8)U/L;C조ALT분별위(47.4±14.6)、(558.5±167.8)、(63.5±21.9)、(48.0.±9.3)U/L,AST분별위(51.8±9.5)、(752.5±112.0)、(56.5 ±20.6)、(51.4±8.6)U/L;술후1 dALT화AST교술전화D조명현승고(P치균<0.01),술후7、14 d소측치여술전비교차이무통계학의의.전새술전후4조실험토BUN화Cr치조간화조내비교,차이균무통계학의의.술후7 d CT시A、B、C 3조류구전유자액화전유침적분포여전새혹전새열료전상비무명현변화.술후14 d CT시A조류구전유자액침적경집중、밀실,B、C량조공5례종류류주전유자액혹전유이위、부분소실.술후14 d,A조종류체적[(6.1±0.6)cm~3]교술전[(7.8±1.4)cm~3]평균축소약21.7%(F=17.56,P<0.01),이술전B、C량조종류체적분별위(7.9±1.1)、(7.8±0.9)cm~3,치료후14 d분별위(9.1±0.8)、(9.3±1.0)cm~3,교술전평균증대16.2%、18.9%(F치분별위25.23、55.50,P치균<0.01).병리검사,전새14 d후,A조종류배사균체80%이상,B、C량조종류배사약30%~50%.결론 전유자액대토VX2간암행선택성간동맥전새열료시안전유효적,구유가행성.
Objective To investigate the changes in function of liver and kidney of the rabbits bearing VX2 liver tumor after transarterial embolization and hyperthermia with magnetic nanoparticles suspended in lipiodol(MN-L) and its therapeutic effect Methods Thirty-two rabbits bearing VX2 liver tumor were randomly divided into four groups and each group contained 8 rabbits The four groups were MN-L embolization hyperthermia group (Group A), MN-L embolization group(Group B),Lipiodol embolization group(Group C), and Control group (Group D), Each rabbit in Group A and B was embolized with 0.5-0.8 ml MN-L through hepatic artery, while each rabbit in Group C was embolized with 0.5-0.8 ml lipiodol.Hyperthermia in alternating magnetic field was performed in Group A after embolization.The remaining groups did not undergo hyperthermia.The rabbits in control group were not treated.The function of liver and kidney of all the animals was measured 1d before embolization,and 1,7,and 14 d after embolization/hyperthermia respectively.Alanine aminotransferase (ALT) and aspartate aminotransaminase (AST) were used to reflect the function of liver,and blood urea nitrogen(BUN) and creatinine (Cr) were used to reflect the function of kidney.CT was performed on all of subjects before and after embolization to determine the embolization effect and the tumor size, and follow-up CT was performed weekly.All of subjects were sacrificed 14 days after embolization/hyperthermia, and their livers, spleens, kidneys and lungs were removed for histopathology examination.The data from every group were analyzed using analysis of variance of repeated measure data.Results On 1 day before embolization and 1,7, and 14 d after embolization/hyperthermia, the function of liver of the rabbits was as follows:Group A:ALT was (43.9±19.0),(795.1±327.1),(67.0±9.3), and(41.9±10.8) U/L respectively,and AST was (50.2±13.6),(1011.2±655.9),(62.4±24.1),and(51.6±7.9) U/L respectively; Group B: ALT was(45.0±19.1),(580.8±160.4),(67.2±31.0),and(47.6±7.8) U/L respectively, and AST was (52.9±20.3),(735.2±186.1),(57.9±24.8),and (50.9±9.8) U/L respectively; Group C: ALT was (47.4±14.6),(558.5±167.8),(63.5±21.9),and (48.0±9.3) U/L respectively, and AST was (51.8±9.5),(752.5±112.0),(56.5±20.6),and(51.4±8.6) U/L respectively.Both ALT and AST mean values of the rabbits were significantly elevated 1 d after embolization/hyperthermia in Group A, B and C, and the data showed statistically significant difference comparing with that before therapy and that of Group D 1 d after therapy (P<0.01).The function of liver showed no statistically significant difference between 7 or 14 days after embolization and 1 day before embolization in Group A,B and C. BUN and Cr mean values in pre-embolization and post-embolization rabbits revealed no statistically significant difference in group A, B, C and D.The MN-L /lipiodol were deposited in the tumor when it was injected, which was validated by CT.To compare with immediate CT after embolization, the MN-L deposited in tumors was not significantly different on CT 7 d after embolization .On the 14 th day after treatment,the MN-L deposited in tumors became concentrative and compact in Group A, while the MN-L/lipiodol deposited at the rim of tumors disappeared on CT in five rabbits of Group B and C.And the tumor size decreased by 21.7% compared to that before treatment in Group A [from (7.8±1.4)cm~3 to(6.1±0.6) cm~3,F=17.56, P<0.01], but tumor size increased by 16.2% and 18.9% in Group B and C respectively [from (7.9±1.1)and (7.8±0.9)cm~3 to (9.1±0.8) and (9.3±1.0)cm~3, F =25.23,55.50, P<0.01].Histopathologically, the tumor of Group A was necrotic for at least 80% 14 day after embolization, while the tumor of Group B and C was necrotic for 30% to 50% .Conclusion Transarterial embolization and hyperthermia with MN-L is safe, effective and feasible on the rabbits bearing VX2 liver tumor.
