本文關(guān)鍵詞： 三氧化二砷 VX2兔 肝癌 血供 阻斷　出處：《福建醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察肝周膜隔絕聯(lián)合三氧化二砷肝區(qū)域雙灌注栓塞治療兔VX2肝癌的療效。方法:新西蘭大白兔32只,開(kāi)腹接種法建立VX2肝癌模型。造模成功的30只VX2肝癌兔按隨機(jī)數(shù)字表法分為A、B、C、D四組。A組(6只):對(duì)照組/靜脈注射組,不開(kāi)腹置管,只經(jīng)耳緣靜脈注射三氧化二砷;B組(8只):TAE聯(lián)合三氧化二砷區(qū)域灌注組;C組(8只):TAVE聯(lián)合三氧化二砷區(qū)域灌注組;D組(8只):TAVE聯(lián)合肝周防粘連隔離膜包裹聯(lián)合三氧化二砷區(qū)域灌注組。造模后2周,手術(shù)開(kāi)腹置管。術(shù)前1d和術(shù)后3、7、14d,抽取四組VX2肝癌兔外周靜脈血檢測(cè)ALT、AST。術(shù)前1d和術(shù)后第14d行胸、腹部CT掃描,計(jì)算腫瘤體積及觀察肺部轉(zhuǎn)移情況;比較各組實(shí)驗(yàn)兔術(shù)后生存時(shí)間。各觀察指標(biāo)結(jié)果以均數(shù)±標(biāo)準(zhǔn)差來(lái)表示。各時(shí)間點(diǎn)各組之間的比較采用單因素方差分析,多組間兩兩比較采用LSD法,各組變化趨勢(shì)之間的比較采用重復(fù)測(cè)量資料的方差分析。各組間肺轉(zhuǎn)移比較采用Pearson Chi-square卡方檢驗(yàn)。Kaplan-Meier法進(jìn)行生存分析,log-rank檢驗(yàn)進(jìn)行組間比較。結(jié)果:1.造模后13d(術(shù)前1d)行CT掃描及造模后2周手術(shù)開(kāi)腹,四組腫瘤均接種成功,成功率100%,腫瘤表面呈灰白色。2.ALT、AST變化情況:術(shù)前1d,四組VX2肝癌兔ALT、AST水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后第3d,B、C、D組ALT、AST水平較A組明顯升高(P0.05),其中,C、D組升高最為明顯;術(shù)后第7d,ALT、AST水平在A組有所上升,B、C、D組開(kāi)始下降,但仍高于A組(P0.05),同時(shí)C組ALT、AST水平高于B組(P0.05),D組ALT水平高于B組(P0.05);術(shù)后第14d,A組ALT、AST水平仍繼續(xù)升高,B、C、D組ALT水平繼續(xù)下降,AST水平有所升高,A組ALT、AST水平較B、C、D組均高(P0.05),同時(shí)C組AST水平高于B組(P0.05)。3.腫瘤體積變化:術(shù)前1d,四組VX2肝癌兔腫瘤體積差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后第14d,四組腫瘤體積增大,B、C、D組較A組腫瘤體積小(P0.05),其中D組腫瘤體積最小。4.肺部轉(zhuǎn)移情況:術(shù)前1d,四組VX2肝癌兔均未發(fā)現(xiàn)肺部轉(zhuǎn)移;術(shù)后第14d,A組肺部轉(zhuǎn)移率最高(P0.05),D組肺轉(zhuǎn)移率較B、C組低(P0.05)。5.中位生存期:A組:21.17±1.60d;B組24.80±1.47d;C組27.00±1.41d;D組32.29±2.56d。B、C、D組生存時(shí)間較A組明顯延長(zhǎng)(P0.05),D組生存時(shí)間最長(zhǎng)(P0.05)。結(jié)論:1.三氧化二砷通過(guò)外周靜脈注射治療VX2肝癌兔,雖然短期內(nèi)對(duì)肝臟損傷較小,但隨著治療時(shí)間延長(zhǎng),將嚴(yán)重影響肝臟功能。并且此種全身化療方法不能很好抑制腫瘤的生長(zhǎng)和降低腫瘤轉(zhuǎn)移率,VX2肝癌兔的生存期較短。2.三氧化二砷聯(lián)合TAVE與聯(lián)合TAE治療VX2肝癌兔相比較,前者在短期內(nèi)會(huì)加重肝臟損傷,但不增加VX2肝癌兔的死亡率。兩種方法抑制腫瘤生長(zhǎng)的能力和降低腫瘤轉(zhuǎn)移率相當(dāng),但均優(yōu)于全身化療。三氧化二砷聯(lián)合TAVE能更好的延長(zhǎng)生存期。3.VX2肝癌兔采用TAVE聯(lián)合肝周防粘連隔離膜包裹聯(lián)合三氧化二砷區(qū)域灌注治療,較其他治療方法能更好的延長(zhǎng)生存時(shí)間,是一種療效較好的治療肝癌的方法。
[Abstract]:Objective: to observe the efficacy of perihepatic membrane isolation combined with arsenic trioxide double perfusion embolization in the treatment of VX2 liver cancer in rabbits. Methods: 32 New Zealand white rabbits. The VX2 hepatoma model was established by abdominal inoculation. Thirty VX2 hepatoma rabbits were randomly divided into four groups: control group and intravenous injection group. Only arsenic trioxide was injected intravenously through the ear margin without abdominal catheterization. Group B (n = 8): combined with arsenic trioxide group (n = 8); Group C (n = 8): group C (n = 8) combined with arsenic trioxide group (n = 8); Group D (n = 8): 1 day before operation and 7 days after operation, 8 rats in group D were encapsulated with antiadhesion isolating membrane around the liver and infused with arsenic trioxide (as). 2 weeks after modeling, abdominal catheterization was performed, 1 day before operation and 7 days after operation. Peripheral venous blood was collected from four groups of VX2 liver cancer rabbits to detect alt AST.The chest and abdominal CT scans were performed 1 day before operation and 14 days after operation to calculate tumor volume and observe lung metastasis. The survival time of experimental rabbits in each group was compared. The results of each observation index were expressed as mean 鹵standard deviation. At each time point, single factor analysis of variance was used to compare each group, and LSD method was used to compare the two groups. Analysis of variance of repeated measurements was used to compare the trend of lung metastasis among groups. Pearson was used to compare lung metastasis among groups. Chi-square chi-square test. Kaplan-Meier method for survival analysis. Log-rank test was compared among groups. Results 1. Ct scan was performed 13 days (1 day before operation) and operation was performed 2 weeks after modeling. All the four groups were successfully inoculated and the success rate was 100%. The changes of alt AST on tumor surface were gray. 2. The level of alt AST in VX2 liver cancer rabbits in the four groups had no significant difference at 1 day before operation (P 0.05). On the 3rd day after operation, the level of alt in group D was significantly higher than that in group A (P 0.05), especially in group D. On the 7th day after operation, the level of alt AST increased in group A and began to decrease in group D, but it was still higher than that in group A (P 0.05) and ALT in group C. The level of AST in group D was higher than that in group B (P 0.05) and the level of ALT in group D was higher than that in group B (P 0.05). The level of ALT in group A continued to decrease on the 14th day after operation. The level of AST in group A was higher than that in group B. The level of AST in group C was higher than that in group B (P 0.05). The change of tumor volume was 1 day before operation. There was no significant difference in tumor volume among the four groups of VX2 liver cancer rabbits (P 0.05). On the 14th day after operation, the tumor volume in group D was smaller than that in group A (P 0.05), and the tumor volume in group D was the smallest. 4. Lung metastasis: 1 day before operation. No lung metastasis was found in VX2 liver cancer rabbits in the four groups. On the 14th day after operation, the lung metastasis rate of group A was the highest and the lung metastasis rate of group D was lower than that of group B C. The median survival time of group A was 21.17 鹵1.60 days. Group B 24.80 鹵1.47 days; Group C 27.00 鹵1.41d; The survival time of group D was significantly longer than that of group A (32.29 鹵2.56 d.BP0.05). Conclusion: 1. Arsenic trioxide is injected into peripheral vein to treat VX2 liver cancer rabbits, although the liver damage is small in the short term, but with the prolongation of treatment time, the survival time of group D is longer than that of P0.050.Conclusion arsenic trioxide can be injected into peripheral vein to treat VX2 liver cancer rabbits. Liver function will be seriously affected. And this systemic chemotherapy method can not well inhibit tumor growth and reduce tumor metastasis rate. The survival time of VX2 liver cancer rabbits was shorter than that of VX2 liver cancer rabbits. Arsenic trioxide combined with TAVE combined with TAE could aggravate liver injury in a short period of time. But the death rate of VX2 liver cancer rabbits was not increased. The ability of both methods to inhibit tumor growth and reduce the rate of tumor metastasis were similar. Arsenic trioxide combined with TAVE could prolong the survival time. 3. VX2 hepatoma rabbits were treated with TAVE combined with antiadhesion isolation membrane and regional infusion of arsenic trioxide. Compared with other treatment methods, it can prolong the survival time better, and is a better therapeutic method for liver cancer.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.7

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