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1.
目的:评价Ad-p53介入栓塞治疗兔VX2肝癌的抑瘤效果及对兔VX2肝癌中p53/MMP-2蛋白表达的影响。方法:将VX2瘤细胞接种于48只新西兰大白兔肝左叶,建立VX2肝癌模型,随机分为四组,每组12只。经股动脉途径行肝固有动脉插管,分别注入生理盐水(对照组)、水化碘油(A组)、Ad-p53(B组)、Ad-p53 水化碘油(C组)。术后1周处死动物,取肿瘤组织制作石蜡切片(HE)染色及免疫组化方法测定p53/MMP-2蛋白的表达。结果:经肝动脉插管介入治疗1周后,各组肿瘤体积均增大,但A、B、C组肿瘤生长受到明显抑制,与对照组比较,有显著性差异。与对照组相比,B组与C组的MMP-2蛋白的表达阳性率降低,差异有统计学意义(P<0.05);转移组的MMP-2蛋白表达阳性率均高于无转移组,具有统计学意义(P<0.05),p53蛋白的表达趋势与MMP-2蛋白一致,p53与MMP-2之间存在相关性(P<0.05)。结论:Ad-p53介入栓塞治疗兔VX2肝癌可抑制肿瘤的生长,减少转移;p53蛋白表达的增高预示肿瘤转移潜能增加,增殖能力增加;MMP-2蛋白表达的增高预示着肿瘤的高转移潜能。  相似文献   

2.
【摘要】 目的 探讨匹立尼酸对肝癌经导管动脉栓塞术(TAE)术后癌旁肝组织中过氧化物酶体增殖物激活受体(PPAR)-α、核因子(NF)-κB和基质金属蛋白酶(MMP)-9表达的影响。方法 构建VX2肝癌兔模型并追踪肿瘤种植和生长情况。造模成功后将60只模型兔随机分为3组(每组20只),对照组不作任何处理,TAE组仅行TAE术,联合治疗组在TAE术前3 d连续注射匹立尼酸,随后行TAE术。化学比色法检测术前术后模型兔外周血中丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平。荧光定量聚合酶链反应检测癌旁肝组织中PPAR-α、NF-κB和MMP-9 mRNA表达。免疫组化法检测术后癌旁肝组织蜡块中PPAR-α、NF-κB和MMP-9蛋白表达。结果 三组模型兔间术前ALT、AST水平差异无统计学意义;联合治疗组术后ALT、AST水平高于对照组,低于TAE组,差异均有显著统计学意义。联合治疗组癌旁组织中PPAR-α mRNA表达显著高于对照组、TAE组,差异均有统计学意义;NF-κB mRNA、MMP-9 mRNA表达显著低于TAE组,差异均有统计学意义,但与对照组比较,差异均无统计学意义。联合治疗组癌旁组织中PPAR-α阳性率(70%)显著高于对照组(30%)、TAE组(20%);NF-κB(30%)、MMP-9(35%)阳性率低于TAE组(65%,75%),但与对照组(20%,25%)差异均无统计学意义。结论 匹立尼酸可缓解肝癌TAE术后癌旁组织炎性反应和肝功能损伤,这可能与其促进PPAR-α表达、抑制NF-κB信号通路及其下游MMP-9表达有关。  相似文献   

3.
目的 探讨p53介入治疗对VX2兔肝癌侵袭转移的影响.方法 开腹方法将VX2瘤细胞分别植入48只新西兰大白兔的肝左叶,建立VX2兔肝癌模型,随机分为4组(12只/组),分别进行肝动脉插管介入治疗,对照组注入生理盐水、A组、B组、C组分别注入水化碘油、Ad-p53、Ad-p53+水化碘油.术后1周处死肿瘤兔,免疫组化方法测定基质金属蛋白酶-2(MMP-2)、增殖细胞核抗原(PCNA)、血管内皮生长因子(VEGF)表达.结果 实验组(A,B,C组)观测到肿瘤生长受到明显抑制,与对照组比较差异有统计学意义(P<0.05).单纯碘油栓塞后,肿瘤区MMP-2、PCNA表达略有降低,VEGF表达略有升高,与对照组比较差异均无统计学意义(P>0.05);Ad-p53组与Ad-p53+水化碘油组的MMP-2、PCNA及VEGF的表达阳性率降低,与对照组相比差异有统计学意义(P<0.05);转移组的MMP-2、PCNA及VEGF的表达阳性率均高于无转移组(P<0.05);MMP-2与VEGF及PCNA之间均存在相关性(P<0.05).绪论MMP-2、VEGF及PCNA的增高预示着肿瘤高转移、高增殖能力,肿瘤血管高形成能力.Ad-p53及Ad-p53+碘油介入治疗可抑制肿瘤的生长,抑制肿瘤新生血管形成,减少转移.  相似文献   

4.
目的 研究射频消融(RFA)与肝动脉栓塞(TAE)联合治疗VX2兔肝移植瘤的疗效.材料与方法将VX2肿瘤块植入实验兔的肝脏内,建立36只兔肝癌模型,随机分为4组,每组9只.A组行单纯RFA治疗,B、C、D组分别在TAE治疗后1、4、7天行RFA治疗.各组在治疗后1、4、7天取标本,观察疗效.结果 毁损范围:A组(2.99±0.18)cm2与B组(3.67±0.32)cm2、C组(3.65±0.29)cm2、D组(3.53±0.16)cm2比较差异有统计学意义(P<0.05),B、C、D组之间比较筹异无统计学意义(P>0.05).结论 在一定时间内TAE与RFA联合治疗可以明显增加肝脏肿瘤的坏死范围,提高坏死率.  相似文献   

5.
目的观察经皮射频消融(RFA)治疗兔小腿VX2肿瘤前后其组织中热休克蛋白70(HSP70)及白介素8(IL-8)表达变化并探讨其免疫的影响。方法取体重约2.5~3.0kg的健康新西兰大白兔31只,以注射细胞悬液的方法分别建立肿瘤模型,模型经检测建立成功后,分为两组,其中实验组20只,对照组10只,静脉麻醉并CT定位病灶成功后,导入消融针消融5min,对照组只导入消融针不进行消融治疗,分别于RFA前及RFA后1、3、7、14天、5个时间点处死4只瘤兔(对照组2只),取消融灶(包含残余肿瘤组织)及消融灶周围5mm以外的正常组织2块标本,聚合酶链式反应(PCR)和免疫印迹(Western Blot)用来检测肿瘤组织HSP70和IL-8的表达。免疫组化检测HSP70的变化,同时观察两组动物肿瘤的大小变化。结果在正常组织中及瘤体组织中HSP70的表达在术后呈现相似的表达趋势,均于术后表达增多,两者均于RFA术后3天开始呈现明显的增多趋势,于7天达到峰值,14天略呈下降;PCR结果亦显示了与免疫组化相似的趋势,而IL-8在术后则表现为低表达的趋势,且在14天最为显著;Western Blot的蛋白定量检测显示,肿瘤组织内,在术前表达较少,在术后表达呈现与免疫组化、PCR相同的趋势,IL-8的表达亦与前相同。结论射频消融治疗肿瘤后,使肿瘤细胞坏死,HSP70表达增加,IL-8水平下降,此则与RFA破坏肿瘤组织,释放细胞因子、肿瘤特异性抗原等激发机体抗肿瘤免疫反应有关。  相似文献   

6.
目的 探索不同温度控制条件下射频消融(RFA)治疗兔VX2肝癌后靶区内肿瘤细胞凋亡及增殖变化.方法 采用开腹组织块法构建兔VX2肝癌模型,随机分为对照组(n=6,未行RFA)和实验组A组(n=24,射频针温度50~70℃)、B组(n=24,射频针温度70~90℃)、C组(n=24,射频针温度90~110℃).实验组分别接受CT引导下不同温控RFA,靶区由消融中心向外周依次分为针道区、消融区和交界区;采用苏木精-伊红(HE)染色观察肿瘤及周围肝组织病理学变化,脱氧核糖核苷酸末端转移酶介导的缺口末端标记法(TUNEL)和增殖细胞核抗原(PCNA)免疫组化法检测各区带肿瘤细胞凋亡及增殖情况.结果 RFA后实验组各组各区带6个时间点(术后即刻,1、3、7、14、21 d)标本肿瘤细胞凋亡指数(AI)和增殖指数(PI)与对照组比较,均有统计学差异(P<0.05);B、C组区带各时间点AI均高于A组(P<0.05),B、C组间无明显差异(P>0.05);术后7、14、21 d时B、C组消融区和交界区PI均低于A组(P<0.05),且术后21 d时C组PI低于B组(P<0.05).结论 RFA温控在50~110℃能达到基本灭活针道区兔VX2肝癌细胞的作用,选择90~110℃温控更利于彻底控制肿瘤.  相似文献   

7.
射频消融(RFA)作为肝癌局部治疗的常用方法,已取得了显著疗效[1-3].影像检查作为随访判断肝癌RFA后疗效的常用手段之一,对于肿瘤的残存和复发、肿瘤浸润的早期发现具有非常重要的作用.笔者旨在通过对兔VX2肝癌RFA后病灶的CT影像和病理的对照分析,以早期鉴别肿瘤残存与术后炎性反应.  相似文献   

8.
目的观察利用射频消融治疗兔小腿VX2肿瘤前后其血清中HSP70(heat shock protein70)、IL-6(interleukin-6)及IL-8(interleukin-8)表达变化及其对抗肿瘤免疫的影响。方法取31只健康新西兰大白兔,体重约2.5~3.0kg。利用注射细胞悬浮液的方法建立兔肿瘤模型,建模完成后,遵循随机原则分为两组:干预治疗组20只,对照组10只;干预组给予5min射频干预,对照组只导入射频消融针,不进行干预。分别于干预前及干预后的1天、3天、7天、14天,五个不同时间点抽取兔耳缘静脉血2ml,以ELISA(Enzyme-linked immunosorbent assay)法检测HSP70、IL-6和IL-8的表达。结果在RFA(hadiofrequency ablation)干预治疗前,HSP70表达水平较低,在干预后逐渐增高,于第7天表达量达到峰值,在14天时略呈降低;IL-6表达在两组中较干预前均增高,但干预组的表达增高量低于对照组,且两组在14天表达有统计差异;IL-8在干预前呈高表达态势,在干预治疗后则呈渐进性降低,对照组亦有逐渐降低趋势,但两组在同时间节点上无统计差异。结论 RFA对兔VX2肿瘤干预性治疗后,可引起HSP70及IL-6表达量升高,却降低了IL-8的表达,此可能与RFA对肿瘤细胞的破坏及对瘤旁组织刺激有关,释放了炎性因子,激发了抗肿瘤的特异性免疫有关,有利于进一步研究VX2肿瘤RFA后的免疫调节。  相似文献   

9.
目的 探讨超声造影(CEUS)与增强CT检查在评价肝肿瘤VX2肝肿瘤模型射频消融(RFA)疗效方面的作用. 资料与方法 9只兔VX2肝肿瘤模型作RFA治疗后1周同时作CEUS与增强CT检查,与病理作对照,比较CEUS与增强CT在评价RFA疗效的准确性. 结果 9只中8只病理发现残留肿瘤灶,1只完全消融,残留灶在CEUS与增强CT上均可见强化.3只炎性反应带能被CEUS正确评价,而增强CT将其中2只误认为是残留灶.1只残留灶位于肋骨下未能被CEUS检出.CEUS、增强CT、两者联合诊断的敏感率、特异性和诊断准确率分别为86%、88%、86%,90%、78%、85%,94%、75%、91%.三组之间差异均无统计学意义(P<0.05). 结论 CEUS与增强CT均能较可靠评价RFA疗效,两者具有良好的相关性和一致性; CEUS与增强CT联合评价可提高评价准确率.  相似文献   

10.
目的:研究肝动脉化疗栓塞术(TACE)联合射频消融(RFA)及125I放射性粒子植入治疗直径≥10 cm的巨块型肝癌的临床效果。 方法:选取经我院临床或病理确诊的直径≥10 cm肝癌患者54例,分为对照组28例,行TACE+RFA治疗;联合组26例,行TACE+RFA+125I放射性粒子植入治疗;比较两组的治疗有效率和临床控制率;所有患者随访1~37个月,采用Kaplan-Meier方法对两组的生存情况进行分析,Log-rank检验比较生存曲线的差异。 结果:联合组的有效率高于对照组(61.5% vs. 32.1%),差异有统计学意义(χ2=4.685,P=0.030)。联合组的中位无进展生存期(PFS)为9个月,高于对照组的5个月,差异有统计学意义(P=0.010)。联合组的中位生存时间11个月,对照组中位生存时间6个月,联合组较对照组有延长趋势,但差异无统计学意义(P=0.079)。 结论:对于直径≥10 cm的巨块型肝癌,TACE、RFA和125I放射性粒子三者序贯治疗在肿瘤无进展生存期、肿瘤缓解率方面较对照组治疗具有优势,实现了化疗栓塞、消融与局部放疗协同作用,不良反应小。  相似文献   

11.
Lee JM  Kim SW  Chung GH  Lee SY  Han YM  Kim CS 《European radiology》2003,13(6):1324-1332
The purpose of this study was to evaluate the feasibility, safety, and effectiveness of radio-frequency (RF) ablation using an internally cooled-tip electrode on renal VX2 tumors implanted in rabbits. Thirty-three rabbits with implanted renal VX2 tumors were divided into two groups: an RF ablation (RFA) group (n=27) and a control group (n=6). In the RFA group, RFA was performed on 27 implanted VX2 tumors using a cooled RF electrode and they were divided into three subgroups according to the follow-up period: acute (1–3 days, n=12); subacute (1–4 weeks, n=9); and chronic (2–7 months, n=6). Contrast-enhanced spiral CT was performed before the RFA and at the day, day 3, weeks 1, 2, 4, and months 2 and 7, after the RFA. The therapeutic efficacy was evaluated by the survival rate, CT, and pathologic findings. The RFA of renal tumors was technically successful in each instance. Complete tumor ablation was achieved in 22 of the 27 rabbits (81.5%) in the RFA group: 5 rabbits survived longer than 8 weeks without any evidence of viable tumor (18.5%) and 17 rabbits were found free of viable tumors when killed (63.0%). Five rabbits showed local tumor relapse and/or hematogenous lung metastasis after ablation (a recurrence rate of 18.5%). There were 11 (40.7%) complications related to the procedure. This experimental study demonstrates the feasibility of RFA therapy to treat renal VX2 tumors in rabbits, although RFA for central tumors carries some major potential complications, including renal arterial injury. Electronic Publication  相似文献   

12.
Radio-frequency ablation (RFA) has been considered as an alternative therapy for liver tumors. A "wet" electrode with interstitial infusion of hypertonic saline was tested for the RFA of liver tumor in rabbits. Seventy-eight liver tumors ( 1.5 to 3.0 cm) were induced in 41 rabbits by VX2 carcinoma implantation. Fifty-one tumors in 27 rabbits were treated with RFA. Under laparotomy, the RF energy was delivered while 5 % saline was infused through the electrode into the tumor at 1 ml/min. Six rabbits with 12 tumors were treated with only intratumoral 5 % saline infusion without RFA. Another 8 rabbits with 15 tumors received sham operation as untreated controls. The efficacy of the therapy was evaluated with survival rate, MRI, microangiography, and histopathology. In the RFA group, 6 rabbits survived longer than 6 months (absolute eradication rate 22.2 %); 12 rabbits were found free of viable tumor at the moment when they were sacrificed (relative eradication rate 44.4 %); 9 rabbits showed local tumor relapse and/or lung metastasis 2-10 weeks after ablation (recurrent rate 33.3 %). In control groups of saline infusion and sham operation, all 14 rabbits died within 3 months (mortality rate 100 %). Three-month survival rates between RFA group and control groups were significantly different (p < 0.05). Findings of MRI, microangiography, and histology supported these outcomes. Radical treatment of liver malignancy in rabbits is possible with the present modified RFA technique. Its clinical usefulness has to be further proven.  相似文献   

13.
RATIONALE AND OBJECTIVE: To evaluate the feasibility, safety, and effectiveness of percutaneous CT-guided transthoracic radiofrequency ablation (RFA) of lung VX2 tumors implanted in rabbits. MATERIALS AND METHODS: Thirty-five rabbits with implanted lung VX2 tumors were divided into two groups, an RFA group (n = 28) and a control group (n = 7). In the RFA group, RFA was performed on VX2 tumors using a 17-gauge internally cooled-tip electrode. Contrast-enhanced CT was performed before the RFA and on the same day, day 3, weeks 1, 2, 3, and months 1, 2, 6, and 9, after the RFA. The therapeutic efficacy was evaluated by CT and pathologic findings. RESULTS: RFA of lung tumors was technically successful in each instance. Complete tumor ablation was achieved in 19 of the 28 rabbits (67.9%) in the RFA group. Nine rabbits (32.1%) showed local tumor relapse and mediastinal lymph nodal or pleural metastasis. The animals in the control group died of end-stage malignancies with diffuse tumor spread and malignant pleural effusion (mean 26 +/- 2.7 days). There were 17 (60.7%) complications related to the procedure, ie, pneumothorax (n = 12), obstructive pneumonia (n = 3), hemothorax (n = 1), and burn (n = 1). RFA of centrally located VX2 tumors (in inner 2/3 of the lung) was more frequently associated with complications than RFA of peripherally located VX2 tumors ( P= 0.02). CONCLUSION: This experimental study demonstrates the feasibility of RFA therapy for treating lung VX2 tumors in rabbits, although RFA for central tumors carries the potential for major complications, including large pneumothorax or obstructive pneumonia.  相似文献   

14.
射频消融(RFA)是一种使肿瘤组织发生凝固性坏死的治疗手段。肝细胞癌RFA术后可能具有完全消融、肿瘤残余、局部肿瘤进展及新发肿瘤等不同的治疗效果。CT、MRI及功能MRI是评价肝细胞癌RFA术后疗效重要的影像学手段。正确认识肝细胞癌RFA术后不同疗效的影像学表现,对于及时、准确地发现术后肿瘤残余、局部肿瘤进展及新发肿瘤尤为重要。针对CT、MRI及功能MRI在肝细胞癌RFA术后疗效评价方面的应用研究进展予以综述。  相似文献   

15.
目的比较无水酒精注射术(PEI)联合射频消融术(RFA)治疗方案与单纯RFA治疗小肝癌的疗效。方法回顾分析我院2006年1月~2008年1月进行的68例小肝癌射频消融治疗患者的临床资料。68例中37例行PEI联合RFA术,31例行单纯RFA术。比较两组肿瘤完全消融率,复发率,复发时间,术后1、2、3年生存率等情况。结果 PEI联合RFA组肿瘤完全消融率91.89%,局部复发率10.81%,局部复发时间(14.22±3.48)月,1、2、3年的生存率分别为89.19%、81.08%和72.97%。单纯RFA组肿瘤完全消融率70.97%,局部复发率32.26%,局部复发时间(9.15±2.68)月,1、2、3年的生存率87.10%、77.42%和48.39%。PEI联合RFA组在肿瘤完全消融率、局部复发率、复发时间、术后3年生存率方面好于单纯RFA组。结论 PEI联合RFA治疗小肝癌疗效优于单纯RFA治疗,在小肝癌的治疗中有重要临床应用价值。  相似文献   

16.
目的:评价甲磺酸阿帕替尼联合经皮肝动脉化疗栓塞术(TACE)治疗中晚期肝癌的疗效及对血清血管内皮生长因子(VEGF)和基质金属蛋白酶(MMP)-9的影响。 方法:选取2015年6月-12月瑞安市人民医院收治的中晚期肝细胞肝癌(HCC)患者46例,随机分为观察组、对照组,各23例,对照组仅采用TACE治疗,观察组在对照组的基础上给予甲磺酸阿帕替尼治疗,比较两组间的疗效、不良反应、血清VEGF及MMP-9水平。 结果:观察组的疾病控制率明显高于对照组(56.52% vs. 26.08%,P<0.05);观察组的半年生存率和1年生存率分别为52.17%和34.78%,对照组为34.78%和21.74%,差异均无统计学意义(P>0.05),但观察组的总生存率高于对照组,差异有统计学意义(34.78% vs. 8.69%,P<0.05)。观察组的不良反应发生率为56.5%,与对照组的65.2%差异无统计学意义。治疗前,两组血清VEGF[(232.54±17.05)ng/ml vs.(233.05±15.23)ng/ml]和MMP-9[(1 857.23±15.31)ng/ml vs.(1883.45±15.42)ng/ml]差异均无统计学意义(P>0.05);术后1个月,观察组VEGF低于对照组[(206.04±13.05)ng/ml vs.(225.36±11.42)ng/ml],MMP-9也低于对照组[(1 604.56±15.25)ng/ml vs.(1 835.21±13.58)ng/ml],差异均有统计学意义(P<0.01)。 结论:TACE联合甲磺酸阿帕替尼治疗中晚期HCC的疗效优于单纯TACE。  相似文献   

17.

Objective

To assess the clinical efficacy, safety, and risk factors influencing local tumor progression, following CT-guided radiofrequency ablation (RFA) of recurrent or residual hepatocellular carcinoma (HCC), around iodized oil retention.

Materials and Methods

Sixty-four patients (M : F = 51 : 13, 65.0 ± 8.2 years old) with recurrent or residual HCC (75 index tumors, size = 14.0 ± 4.6 mm) had been treated by CT-guided RFA, using retained iodized oil as markers for targeting. The technical success, technique effectiveness rate and complications of RFA were then assessed. On pre-ablative and immediate follow-up CT after RFA, we evaluated the size of enhancing index tumors and iodized oil retention, presence of abutting vessels, completeness of ablation of iodized oil retention, and the presence of ablative margins greater than 5 mm. Also, the time interval between transarterial chemoembolization and RFA was assessed. The cumulative local tumor progression rate was calculated using the Kaplan-Meier method, and the Cox proportional hazards model was adopted, to clarify the independent factors affecting local tumor progression.

Results

The technical success and technique effectiveness rate was 100% and 98.7%, respectively. Major complications were observed in 5.6%. The cumulative rates of local tumor progression at 1 and 2 years were 17.5% and 37.5%, respectively. In multivariate analyses, partial ablation of the targeted iodized oil retention was the sole independent predictor of a higher local tumor progression rate.

Conclusion

CT-guided RFA of HCC around iodized oil retention was effective and safe. Local tumor progression can be minimized by complete ablation of not only index tumors, but targeted iodized oil deposits as well.  相似文献   

18.
目的探讨经皮射频消融术(RFA)治疗小肝癌的效果。方法将经影像学、病理学检查证实的小肝癌患者116例分为两组,分别行RFA和手术切除治疗,比较两组术后并发症的发生、术后1年两组肿瘤复发率及1、2、3年生存率。结果 RFA治疗组并发症发生率明显低于手术组,两组术后1年肿瘤复发率及1、2、3年生存率无统计学差异。结论对于小肝癌,肝功能不能耐受手术治疗或肿瘤实质位于靠近主要血管、胆管,切除困难的患者,RFA治疗具有与手术相同的效果,且并发症少。  相似文献   

19.
目的:探讨MRI联合血清微小RNA(micro RNA,miR)-204水平对原发性肝癌射频消融(RFA)术后疗效及复发的预测价值.方法:选择2019年8月至2020年8月于本院行RFA治疗的原发性肝癌患者作为研究对象.于RFA术前一周内对研究对象行MRI检查,记录表观扩散系数(ADC)值;采用定量实时聚合酶联反应法测...  相似文献   

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