中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2014年
4期
753-756
,共4页
林继宗%王晨虎%陈署贤%林楠%胡昆鹏%方和平%许瑞云
林繼宗%王晨虎%陳署賢%林楠%鬍昆鵬%方和平%許瑞雲
림계종%왕신호%진서현%림남%호곤붕%방화평%허서운
癌,肝细胞%动脉化疗栓塞%碘油沉积%血管内皮因子%微血管密度
癌,肝細胞%動脈化療栓塞%碘油沉積%血管內皮因子%微血管密度
암,간세포%동맥화료전새%전유침적%혈관내피인자%미혈관밀도
Carcinoma,hepatocellular%Arterial chemoembolization%Lipiodol retention%Vascular endothelial growth factor%Microvascular density
目的 观察兔肝VX2肝癌经肝动脉化疗栓塞(TACE)术后碘油沉积及血管变化,为确定TACE术后联合射频消融(RFA)治疗最佳时间提供实验基础.方法 采用“开腹瘤块包埋法”建立兔肝VX2肝癌模型,成模后行TACE术.将TACE术后肿瘤血管完全闭塞的30只兔肝癌模型根据观察时间点的不同,分为TACE术后24、48 h,第7、14、21、28天共6组,通过影像学检查(CT扫描及动脉造影)和病理切片染色法观察各组肿瘤碘油沉积及微血管的变化.结果 TACE术后24～48 h肿瘤内碘油沉积完全,瘤周正常肝组织亦可见较多碘油沉积;7d后瘤周肝组织内碘油沉积减少,28 d后肿瘤内碘油沉积不全;24 h～21 d肝动脉造影均未见肿瘤染色,28 d后肿瘤局部可见云雾状染色.TACE术后21 d肿瘤包膜内及肿瘤间质内有少量散在的小血管,28 d肿瘤包膜内及肿瘤间质可见较多小血管.术后各组血管内皮生长因子(VEGF)阳性率逐渐升高,各组VEGF阳性率分别为(24.0±7.8)％、(27.0±9.1)％、(36.2±8.4)％、(53.0±9.5)％、(72.4±7.3)％、(73.6±12.1)％,术后48 h、7、14、21d各组VEGF阳性率比较差异均有统计学意义(P＜0.05),而21 d与28 d比较差异无统计学意义(P＞0.05).术后各组微血管密度(MVD)分别为10.8±5.3、12.0±6.0、12.6±3.8、24.3±5.4、38.8±9.5、39.6±6.2,术后第7天开始MVD呈上升趋势,7、14、21d各组MVD比较差异均有统计学意义(P＜0.05),而21 d与28 d比较差异无统计学意义(P＞0.05).结论 TACE术后48 h内碘油沉积覆盖范围最广,血管闭塞最完全;7d后肿瘤组织VEGF表达上调,并随时间延长逐渐升高,在术后21d达到高峰;TACE术后7～ 14d肿瘤组织内微血管开始形成,21 d有小血管出现,28 d血管形成明显.
目的 觀察兔肝VX2肝癌經肝動脈化療栓塞(TACE)術後碘油沉積及血管變化,為確定TACE術後聯閤射頻消融(RFA)治療最佳時間提供實驗基礎.方法 採用“開腹瘤塊包埋法”建立兔肝VX2肝癌模型,成模後行TACE術.將TACE術後腫瘤血管完全閉塞的30隻兔肝癌模型根據觀察時間點的不同,分為TACE術後24、48 h,第7、14、21、28天共6組,通過影像學檢查(CT掃描及動脈造影)和病理切片染色法觀察各組腫瘤碘油沉積及微血管的變化.結果 TACE術後24～48 h腫瘤內碘油沉積完全,瘤週正常肝組織亦可見較多碘油沉積;7d後瘤週肝組織內碘油沉積減少,28 d後腫瘤內碘油沉積不全;24 h～21 d肝動脈造影均未見腫瘤染色,28 d後腫瘤跼部可見雲霧狀染色.TACE術後21 d腫瘤包膜內及腫瘤間質內有少量散在的小血管,28 d腫瘤包膜內及腫瘤間質可見較多小血管.術後各組血管內皮生長因子(VEGF)暘性率逐漸升高,各組VEGF暘性率分彆為(24.0±7.8)％、(27.0±9.1)％、(36.2±8.4)％、(53.0±9.5)％、(72.4±7.3)％、(73.6±12.1)％,術後48 h、7、14、21d各組VEGF暘性率比較差異均有統計學意義(P＜0.05),而21 d與28 d比較差異無統計學意義(P＞0.05).術後各組微血管密度(MVD)分彆為10.8±5.3、12.0±6.0、12.6±3.8、24.3±5.4、38.8±9.5、39.6±6.2,術後第7天開始MVD呈上升趨勢,7、14、21d各組MVD比較差異均有統計學意義(P＜0.05),而21 d與28 d比較差異無統計學意義(P＞0.05).結論 TACE術後48 h內碘油沉積覆蓋範圍最廣,血管閉塞最完全;7d後腫瘤組織VEGF錶達上調,併隨時間延長逐漸升高,在術後21d達到高峰;TACE術後7～ 14d腫瘤組織內微血管開始形成,21 d有小血管齣現,28 d血管形成明顯.
목적 관찰토간VX2간암경간동맥화료전새(TACE)술후전유침적급혈관변화,위학정TACE술후연합사빈소융(RFA)치료최가시간제공실험기출.방법 채용“개복류괴포매법”건립토간VX2간암모형,성모후행TACE술.장TACE술후종류혈관완전폐새적30지토간암모형근거관찰시간점적불동,분위TACE술후24、48 h,제7、14、21、28천공6조,통과영상학검사(CT소묘급동맥조영)화병리절편염색법관찰각조종류전유침적급미혈관적변화.결과 TACE술후24～48 h종류내전유침적완전,류주정상간조직역가견교다전유침적;7d후류주간조직내전유침적감소,28 d후종류내전유침적불전;24 h～21 d간동맥조영균미견종류염색,28 d후종류국부가견운무상염색.TACE술후21 d종류포막내급종류간질내유소량산재적소혈관,28 d종류포막내급종류간질가견교다소혈관.술후각조혈관내피생장인자(VEGF)양성솔축점승고,각조VEGF양성솔분별위(24.0±7.8)％、(27.0±9.1)％、(36.2±8.4)％、(53.0±9.5)％、(72.4±7.3)％、(73.6±12.1)％,술후48 h、7、14、21d각조VEGF양성솔비교차이균유통계학의의(P＜0.05),이21 d여28 d비교차이무통계학의의(P＞0.05).술후각조미혈관밀도(MVD)분별위10.8±5.3、12.0±6.0、12.6±3.8、24.3±5.4、38.8±9.5、39.6±6.2,술후제7천개시MVD정상승추세,7、14、21d각조MVD비교차이균유통계학의의(P＜0.05),이21 d여28 d비교차이무통계학의의(P＞0.05).결론 TACE술후48 h내전유침적복개범위최엄,혈관폐새최완전;7d후종류조직VEGF표체상조,병수시간연장축점승고,재술후21d체도고봉;TACE술후7～ 14d종류조직내미혈관개시형성,21 d유소혈관출현,28 d혈관형성명현.
Objective To observe the change of lipiodol retention and neovascularization in rabbits bearing VX2 liver tumor after transcatheter arterial chemoembolization (TACE).Methods The models bearingVX2 liver tumor in 30 rabbits were randomly divided into group A (24 h),B (48 h),C (7 days),D (14 days),and E (28 days) after TACE.Imageologic examinations,including CT scan and angiography,were done to observe the lipiodol retention and neovessels.HE staining and immunohistochemistry staining for vascular endothelial growth factor (VEGF) and CD34 were used to evaluate the neovascularization in tumor after TACE.Results Lodized oil distributed in and around liver tumor in 48 h.Iodized oil around liver tumor became less at 7th day and disappeared at 14th day.Clearance of iodized oil in liver tumor was observed at 28th day.No vessels were seen from 24 h to 21st day.Smoke-like staining could be observed at 28th day by angiography.Positive rate of VEGF (％) and micro vascular density (MVD) was increased in each group.VEGF positive rate from group A to F was (24.0 ± 7.8) ％,(27.0 ± 9.1) ％,(36.2±8.4)％,(53.0 ±9.5)％,(72.4 ±7.3)％,(73.6±12.1)％ respectively.Differences in VEGF positive rate among groupB,C,D,E were statistically significant.MVD from group A to F was 10.8 ± 5.3,12.0 ± 6.0,12.6 ± 3.8,24.3 ± 5.4,38.8 ± 9.5,39.6 ± 6.2 respectively.Differences in MVD among group C,D,E are statistically significant.Conclusion Lodized oil distributes in largest area in 24-48 h after TACE.VEGF is over-expressed at 7th day after TACE,and reaches peak at 21st day after TACE.Microvessels begin to appear between 7th and 14th day.Small vessels come out at 21st day.Neovascularization is obvious at 28th day.
