CAJ | 학술논문

目的：探讨聚甲基丙烯酸甲酯（PMMA）骨水泥对兔脊柱VX2肿瘤的杀伤作用。方法成功建立兔VX2脊柱转移肿瘤模型18只，随机分为A、B、C组，每组各6只，在CT导下向VX2肿瘤中心分别注入PMMA 或生理盐水，其中A组注入PMMA 0．3 ml、B组注入PMMA 0．1 ml、C组注入生理盐水0．3 ml。术后24 h处死模型兔，A、B组分别于距离PMMA团块边缘1、5、10、15 mm处不同方向各取4个肿瘤组织块，C组于瘤体中心至表面不同的4个位置各取1块肿瘤组织，采用脱氧核糖核苷酸末端转移酶介导的缺口末端标记（TUNEL）法检测肿瘤细胞凋亡率。结果16只模型兔成功注入PMMA骨水泥， A、B组手术成功率均为5/6，C组为6/6，无显著性差异。 A组距PMMA 边缘1、5、10 mm 处肿瘤细胞平均凋亡率分别为（65．75±18．81）%、（50．00±14．24）%、（14．95±8．98）%，与对照组（9．79±5．24）%相比差异均有统计学意义（P<0．05）；15 mm处肿瘤细胞平均凋亡率为（10．30±8．13）%，与对照组相比差异无统计学意义。 B组距PMMA边缘1、5 mm处肿瘤细胞平均凋亡率分别为（49．20±15．57）%、（17．75±9．28）%，与对照组相比差异均有统计学意义（P<0．05），其余观测点无显著性差异。 A、B两组距PMMA边缘1、5、10 mm处肿瘤细胞平均凋亡率比较，差异均有统计学意义（P<0．001）。结论 PMMA可促进肿瘤细胞凋亡，适量增加PMMA注入量可增加肿瘤细胞凋亡范围。
목적：탐토취갑기병희산갑지（PMMA）골수니대토척주VX2종류적살상작용。방법성공건립토VX2척주전이종류모형18지，수궤분위A、B、C조，매조각6지，재CT도하향VX2종류중심분별주입PMMA 혹생리염수，기중A조주입PMMA 0．3 ml、B조주입PMMA 0．1 ml、C조주입생리염수0．3 ml。술후24 h처사모형토，A、B조분별우거리PMMA단괴변연1、5、10、15 mm처불동방향각취4개종류조직괴，C조우류체중심지표면불동적4개위치각취1괴종류조직，채용탈양핵당핵감산말단전이매개도적결구말단표기（TUNEL）법검측종류세포조망솔。결과16지모형토성공주입PMMA골수니， A、B조수술성공솔균위5/6，C조위6/6，무현저성차이。 A조거PMMA 변연1、5、10 mm 처종류세포평균조망솔분별위（65．75±18．81）%、（50．00±14．24）%、（14．95±8．98）%，여대조조（9．79±5．24）%상비차이균유통계학의의（P<0．05）；15 mm처종류세포평균조망솔위（10．30±8．13）%，여대조조상비차이무통계학의의。 B조거PMMA변연1、5 mm처종류세포평균조망솔분별위（49．20±15．57）%、（17．75±9．28）%，여대조조상비차이균유통계학의의（P<0．05），기여관측점무현저성차이。 A、B량조거PMMA변연1、5、10 mm처종류세포평균조망솔비교，차이균유통계학의의（P<0．001）。결론 PMMA가촉진종류세포조망，괄량증가PMMA주입량가증가종류세포조망범위。
Objective To investigate the killing effect of polymethylmethacrylate (PMMA) on spinal metastasis of transplanted VX2 carcinoma in experimental rabbit models. Methods Spinal metastasis of transplanted VX2 carcinoma model was successfully established in 18 rabbits. The experimental rabbits were randomly and equally divided into three groups with 6 rabbits in each group. Under CT guidance , PMMA or saline was injected into the center of VX2 tumor; in group A 0.3 ml of PMMA was used, in group B 0.1 ml of PMMA was used and in group C (control group) 0.3 ml saline was used. Twenty-four hours after the injection, the animals were sacrificed. Four tissue samples were obtained from the sites at 1 mm , 5 mm, 10 mm and 15 mm away from the PMMA mass in each rabbit of group A and group B , while four tissue samples were collected from different four sites from the tumor ’s center to border in each rabbit of group C. TdT-mediated dUTP nick-end labeling (TUNEL) method was used to determine the tumor cell apoptosis rate. Results After successful establishment of rabbit model, injection of PMMA was performed in sixteen among the eighteen rabbits. Technical success rates were 83.3% in both group A and B, and the success rate was 100% in group C. The difference in technical success rate was not significant. The mean tumor cell apoptosis rates of spinal VX2 carcinoma at 1 mm, 5 mm and 10 mm away from the PMMA mass in group A were (65.75±18.81)%, (50.00±14.24)% and(14.95±8.98)% respectively. The mean apoptosis rate in the control group was (9.79 ±5.24)%; the differences between the group A and the control group were statistically significant (P<0.05). The mean tumor cell apoptosis rate of spinal VX2 carcinoma at 15 mm away from the PMMA mass in group A was (10.30 ±8.13)%, which was not significantly different with that of the control group. The mean tumor cell apoptosis rates of spinal VX2 carcinoma at 1 mm and 5 mm away from the PMMA mass in group B were (49.20±15.57)% and(17.75±9.28)% respectively, which was significantly different with that of the control group(P<0.05); the mean tumor cell apoptosis rates at 10 mm and 15 mm away from the PMMA mass in group B were not significantly different with those of the control group. Statistically significant differences in the mean tumor cell apoptosis rates determined at 1 mm, 5 mm and 10 mm away from the PMMA mass existed between group A and group B(P<0.001). Conclusion PMMA can promote the apoptosis of tumor cells, properly increasing the injected amount of PMMA can enlarge the extent of tumor cell apoptosis.