【摘要】：目的:研究同時(shí)經(jīng)肝動(dòng)脈灌注載阿霉素納米金(doxorubicin-loaded gold nanoparticles,Dox-AuNPs)和利用碘化油行肝動(dòng)脈栓塞術(shù)后,聯(lián)合近紅外光照射行光熱消融治療兔VX-2肝癌的有效性和安全性。材料與方法:40只新西蘭大白兔隨機(jī)分為5組,每組8只,分別為載阿霉素納米金-碘油栓塞聯(lián)合光熱消融組(A組),載阿霉素納米金-碘油栓塞組(B組),碘油-阿霉素混懸液栓塞組(C組),單純碘油栓塞組(D組)和生理鹽水組(E組)。建立兔VX-2移植性肝癌模型,于建模后2周分別利用不同實(shí)驗(yàn)組藥物及方法行介入治療。分別于介入治療當(dāng)日,介入術(shù)后3天、7天、14天行肝臟增強(qiáng)CT檢查,評(píng)估腫瘤體積變化;于介入治療當(dāng)日,介入術(shù)后3天、7天、14天抽血化驗(yàn)肝腎功,評(píng)估肝腎功能變化。每組8只兔,隨機(jī)選擇4只于介入治療后14天處死,觀察大體標(biāo)本特點(diǎn),取腫瘤組織行病理及免疫組化檢查;每組另4只兔飼養(yǎng)至死亡,統(tǒng)計(jì)比較各組術(shù)后總生存期。結(jié)果:各組術(shù)前基線值無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。所有動(dòng)物均成功進(jìn)行介入治療且存活至術(shù)后14天,均未出現(xiàn)嚴(yán)重并發(fā)癥。A～E五組實(shí)驗(yàn)兔術(shù)前腫瘤體積分別為1.38±0.71、1.27±0.62、1.52±0.86、1.45±1.04、1.35±0.48cm3;術(shù)后 3 天腫瘤體積分別為 1.35±0.69、1.30±1.02、1.48±1.21、1.50±0.86、1.40±0.76 cm3;術(shù)后 7 天腫瘤體積分別為 1.44±0.72、2.85±2.03、6.79±2.87、6.18±3.21、7.38±3.36cm3;術(shù)后 14 天腫瘤體積分別為 3.01±1.89、4.34±2.32、8.86±3.49、9.02±4.38、18.7±10.7cm3,術(shù)后 7、14 天組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。A～E 組術(shù)后生存期分別為 25.3±3.1、21.5±3.4、20.3±4.7、20.5±3.4、17.0±2.7 天,組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。A～E組病理顯示鏡下腫瘤細(xì)胞壞死率分別為(%)3.55±1.11、2.04±1.76、1.76±1.70、1.60±0.92、0.27±0.29,組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。A～E組免疫組化顯示鏡下腫瘤內(nèi)微血管密度分別為1.8±0.7、3.2±1.3、3.9±1.2、3.8±1.6、2.5±1.0條,組間比較有統(tǒng)計(jì)學(xué)差異(P0.05);鏡下VEGF積分光密度值分別為:2942.1±649.3、5686.4±2393.1、8364.7±3979.1、7523.6±3584.6、20597.8±9058.0,組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。A組同B、C、D三組比較,ALT、AST值在術(shù)后3、7、14天均無明顯統(tǒng)計(jì)學(xué)差異(P0.05),同E組比較,ALT、AST值在術(shù)后3、7、14天均有明顯統(tǒng)計(jì)學(xué)差異(P0.05);各組術(shù)前,術(shù)后3、7、14天CREA、UREA值均無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:本研究通過對(duì)比研究載阿霉素納米金、肝動(dòng)脈栓塞、光熱消融三者聯(lián)合與載阿霉素納米金、肝動(dòng)脈栓塞兩者聯(lián)合及傳統(tǒng)肝動(dòng)脈化療栓塞等不同方法治療兔VX-2肝癌的療效及安全性,表明載阿霉素納米金、肝動(dòng)脈栓塞、光熱消融三者聯(lián)合可提高兔VX-2肝癌的治療效果,且未額外增加肝腎毒性,較為安全。
[Abstract]:Objective: to study the efficacy and safety of simultaneous transarterial infusion of doxorubicin nanogold (doxorubicin-loaded gold nanoparticles,Dox-AuNPs) and lipiodol for hepatic artery embolization combined with near-infrared irradiation in the treatment of rabbit VX-2 liver cancer. Materials and methods: forty New Zealand rabbits were randomly divided into 5 groups with 8 rabbits in each group. Doxorubicin nano-gold-lipiodol embolization combined with photothermal ablation group (group A), doxorubicin nano-gold-lipiodol embolization group (group B), lipiodo-doxorubicin suspension embolization group (group C), simple lipiodol embolization group (group D) and saline group (group E). The VX-2 transplanted liver cancer model was established in rabbits. Two weeks after modeling, different drugs and methods were used for interventional therapy in different experimental groups. On the day of interventional therapy, 3 days, 7 days and 14 days after interventional therapy, liver enhanced CT was performed to evaluate the changes of tumor volume, and on the day of interventional therapy, 3, 7 and 14 days after interventional therapy, blood samples were taken to test liver and kidney function to evaluate the changes of liver and kidney function. Eight rabbits in each group were randomly selected to be killed 14 days after interventional therapy, the characteristics of gross specimens were observed, and the tumor tissues were taken for pathological and immunohistochemical examination, and 4 rabbits in each group were raised to death, and the total survival time of each group was compared statistically. Results: there was no significant difference in preoperative baseline value in each group (P0.05). All animals were successfully treated with interventional therapy and survived until 14 days after operation. 鍧囨湭鍑虹幇涓ラ噸騫跺彂鐥，

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