肝切除术后肝再生对大鼠结肠癌肝转移灶生长的影响

目的 探讨肝再牛进程触发大鼠结肠痛肝转移残肝内隐性转移灶进展的发生机制.方法 采用肝包膜下种植建立结肠癌肝转移大鼠模型,随机分为假手术组、37%肝切除组和70%肝切除组;采用腹膜后注射建市结肠癌腹膜后转移模型,随机分为假手术组和70%肝切除组.手术后3周处死动物,测定肝内转移瘤量、再生肝重及腹膜后瘤结节重.在含有肝切除后24 h和14 d的门静脉血清培养基中进行结肠癌细胞Lovo体外培养,5.溴脱氧尿核苷(5-BrdU)DNA掺入法检测细胞增殖反应.结果 手术切除明显促进70%肝切除组肝内残留癌牛长(P<0.05),对37%肝切除组肝内残留癌和结肠癌腹膜后转移瘤牛长无促进作用(P>0.05);肝切后24 h门静脉血清组5-BrdU DNA掺人率从第72小时开始增加,至第120小时呈持续增加趋势(P<0.05);肝切后14 d门静脉血清对结肠癌细胞生长无明显刺激作用(P>0.05).结论 结肠癌肝转移切除术后可诱发肝内微小残留灶的进展,并不通过血液循环全身性释放,对肝外转移瘤并不发挥作用.肝切除范围与诱发肿瘤生长有关,只有肝切除达到一定程度时,才足以刺激肿瘤生长.

Influence of Liver regeneration after partial hepatectomy on the development of liver metastasis of colon cancer in rats

Objective To investigate the stimulated effect of liver regeneration on colon cancer cells in remnant liver in rats. Methods Rat models with liver metastases or retro-peritoneal metastases of colon cancer were established: animals underwent 37% or 70% liver resection and were compared with a sham laparotomy( 15, 25, 15 cases, respectively). Metastases were performed two weeks before resection. Rats were killed 3 weeks after the resection. Total body weight, liver and tumor weights were recorded. The human colon adenocarcinoma cell line Lovo was cultured in the presence of portal serum withdrawn 24 hours and 14 days after partial hepatectomy(PH). DNA synthesis was assessed by flow cytometry analysis for 5-Bromodeoxyuridine (5-BrdU) incorporation. Results The tumor growth was accelerated in the remnant liver in 70% PH group, but the tumors in 37% PH group and retro-peritoneal site were not influenced by PH. Compared with the control group, after cultured 72 hours with portal serum withdrawn 24 h after PH, a higher 5-BrdU incorporation was found in the Lovo cell lines (P < 0. 05 ), and it reached the peak after 120 hours of culture( P < 0. 05 ). No difference was found between the groups when cultured with the portal serum withdrawn 14 d after PH ( P > 0. 05 ). Conclusions PH may accelerate the growth of residual microscopic tumor in the liver which contributes to local recurrence. It has no systemic effect and effects on the cancer cell lines inextrahepatic sites. The excision extension is related to the stimulating effects on the cancer cell line, and subtotal hepatectomy is presumably a major determinant.