CAJ | 학술논문

目的探讨肝再牛进程触发大鼠结肠痛肝转移残肝内隐性转移灶进展的发生机制.方法采用肝包膜下种植建立结肠癌肝转移大鼠模型,随机分为假手术组、37%肝切除组和70%肝切除组;采用腹膜后注射建市结肠癌腹膜后转移模型,随机分为假手术组和70%肝切除组.手术后3周处死动物,测定肝内转移瘤量、再生肝重及腹膜后瘤结节重.在含有肝切除后24 h和14 d的门静脉血清培养基中进行结肠癌细胞Lovo体外培养,5.溴脱氧尿核苷(5-BrdU)DNA掺入法检测细胞增殖反应.结果手术切除明显促进70%肝切除组肝内残留癌牛长(P<0.05),对37%肝切除组肝内残留癌和结肠癌腹膜后转移瘤牛长无促进作用(P>0.05);肝切后24 h门静脉血清组5-BrdU DNA掺人率从第72小时开始增加,至第120小时呈持续增加趋势(P<0.05);肝切后14 d门静脉血清对结肠癌细胞生长无明显刺激作用(P>0.05).结论结肠癌肝转移切除术后可诱发肝内微小残留灶的进展,并不通过血液循环全身性释放,对肝外转移瘤并不发挥作用.肝切除范围与诱发肿瘤生长有关,只有肝切除达到一定程度时,才足以刺激肿瘤生长.
목적 탐토간재우진정촉발대서결장통간전이잔간내은성전이조진전적발생궤제.방법 채용간포막하충식건립결장암간전이대서모형,수궤분위가수술조、37%간절제조화70%간절제조;채용복막후주사건시결장암복막후전이모형,수궤분위가수술조화70%간절제조.수술후3주처사동물,측정간내전이류량、재생간중급복막후류결절중.재함유간절제후24 h화14 d적문정맥혈청배양기중진행결장암세포Lovo체외배양,5.추탈양뇨핵감(5-BrdU)DNA참입법검측세포증식반응.결과 수술절제명현촉진70%간절제조간내잔류암우장(P<0.05),대37%간절제조간내잔류암화결장암복막후전이류우장무촉진작용(P>0.05);간절후24 h문정맥혈청조5-BrdU DNA참인솔종제72소시개시증가,지제120소시정지속증가추세(P<0.05);간절후14 d문정맥혈청대결장암세포생장무명현자격작용(P>0.05).결론 결장암간전이절제술후가유발간내미소잔류조적진전,병불통과혈액순배전신성석방,대간외전이류병불발휘작용.간절제범위여유발종류생장유관,지유간절제체도일정정도시,재족이자격종류생장.
Objective To investigate the stimulated effect of liver regeneration on colon cancer cells in remnant liver in rats. Methods Rat models with liver metastases or retro-peritoneal metastases of colon cancer were established: animals underwent 37% or 70% liver resection and were compared with a sham laparotomy( 15, 25, 15 cases, respectively). Metastases were performed two weeks before resection. Rats were killed 3 weeks after the resection. Total body weight, liver and tumor weights were recorded. The human colon adenocarcinoma cell line Lovo was cultured in the presence of portal serum withdrawn 24 hours and 14 days after partial hepatectomy(PH). DNA synthesis was assessed by flow cytometry analysis for 5-Bromodeoxyuridine (5-BrdU) incorporation. Results The tumor growth was accelerated in the remnant liver in 70% PH group, but the tumors in 37% PH group and retro-peritoneal site were not influenced by PH. Compared with the control group, after cultured 72 hours with portal serum withdrawn 24 h after PH, a higher 5-BrdU incorporation was found in the Lovo cell lines (P < 0. 05 ), and it reached the peak after 120 hours of culture( P < 0. 05 ). No difference was found between the groups when cultured with the portal serum withdrawn 14 d after PH ( P > 0. 05 ). Conclusions PH may accelerate the growth of residual microscopic tumor in the liver which contributes to local recurrence. It has no systemic effect and effects on the cancer cell lines inextrahepatic sites. The excision extension is related to the stimulating effects on the cancer cell line, and subtotal hepatectomy is presumably a major determinant.