CAJ | 학술논문

目的评估热消融术后残留肝癌病灶的生物学活性以及联合索拉非尼对残留肿瘤组织增殖及血管新生的影响.方法建立兔VX2移植肝癌模型,随机分为三组:空白对照组(n=7)、微波消融组(n=7)、以及微波消融联合索拉非尼治疗组(n=7).微波消融参数设定为20 W×1 min,肿瘤均有残留.对照组行开腹假手术.联合治疗组术后1～10 d每日以索拉非尼灌胃,剂量20 mg/kg;对照组与消融组以等量生理盐水灌胃.观察治疗前后肿瘤体积变化.免疫组化检测残余肿瘤组织CD31与增殖细胞核抗原(PCNA)表达,计算微血管密度(MVD)与增殖指数(PI).结果与对照组比较,消融组治疗后10 d病灶整体有所增大,差异有统计学意义(P＜0.05)；残余肿瘤组织MVD、PI表达增加,差异有统计学意义(P＜0.05).与消融组比较,联合组治疗后10 d病灶体积缩小,差异有统计学意义(P＜0.05)；肿瘤组织MVD、PI表达下降,差异有统计学意义(P＜0.05).结论索拉非尼能够有效抑制微波消融术后残余肿瘤组织的过度增殖与血管新生.
목적 평고열소융술후잔류간암병조적생물학활성이급연합색랍비니대잔류종류조직증식급혈관신생적영향.방법 건립토VX2이식간암모형,수궤분위삼조:공백대조조(n=7)、미파소융조(n=7)、이급미파소융연합색랍비니치료조(n=7).미파소융삼수설정위20 W×1 min,종류균유잔류.대조조행개복가수술.연합치료조술후1～10 d매일이색랍비니관위,제량20 mg/kg;대조조여소융조이등량생리염수관위.관찰치료전후종류체적변화.면역조화검측잔여종류조직CD31여증식세포핵항원(PCNA)표체,계산미혈관밀도(MVD)여증식지수(PI).결과 여대조조비교,소융조치료후10 d병조정체유소증대,차이유통계학의의(P＜0.05)；잔여종류조직MVD、PI표체증가,차이유통계학의의(P＜0.05).여소융조비교,연합조치료후10 d병조체적축소,차이유통계학의의(P＜0.05)；종류조직MVD、PI표체하강,차이유통계학의의(P＜0.05).결론 색랍비니능구유효억제미파소융술후잔여종류조직적과도증식여혈관신생.
Objective To evaluate the viability of residual tumor after insufficient thermal ablation of rabbit VX2 liver tumor and investigated the efficacy of sorafenib as an adjuvant therapy.Methods Twenty-one rabbits were implanted with VX2 tumor to establish orthotopic liver tumor models.They were allocated randomly into 3 groups:control (n =7),ablation (n =7),and combination treatment (n =7).Microwave coagulation therapy was conducted with 20 W for 1 min and viable tumor tissue remained at the periphery.A laparotomy was performed in the control group.Sorafenib was given at 20 mg/kg/d during the following 10 days in the combination treatment group,and saline was given to the control and ablation group.Tumor volume was recorded before and after treatment,immunohistochemistry detected CD31 and proliferating cell nuclear antigen (PCNA) expression,and the micro-vessel density (MVD) and proliferation index (PI) were calculated accordingly.Results Ten days after insufficient ablation,tumor volume of the ablation group was larger than that of the control group (P ＜0.05).The MVD and PI of residual tumor were higher compared with those of the control group (P ＜ 0.05).With adjuvant therapy of sorafenib after insufficient ablation,tumor volume showed a decrease on the 10th day compared with tumors undergoing insurfficient ablation alone (P ＜ 0.05).The MVD and PI of residual tumor were lower than those of the ablation group (P ＜0.05).Conclusion Insufficient thermal ablation promotes residual tumor progression,but adjuvant therapy of sorafenib serves as an effective way to suppress the overgrowth and neovasculation of the residual tumor.