经皮瘤内注射32P-GMS治疗肝癌——剂量与生物效应的实验研究

目的探讨经皮瘤内注射不同剂量^32P-玻璃微球（^32P-GMS）后的病理改变基础及其与MRI表现的对照关系，评价MRI在让P-GMS治疗中的应用价值。材料与方法选用24只新西兰大白兔，使用VX2瘤株建立肝肿瘤模型，经皮瘤内注射37、74、111和148MBq的^32P-GMS，分批处死后取注药部位肿瘤组织，在光、电镜下观察病理变化，明确放射性照射对肿瘤细胞的损害程度；同时对注药前后各组动物肝脏行MRI检查。结果病理观察发现瘤内注射^32P-GMS剂量与其对肿瘤细胞的放射性损害相关，并可能累及正常肝脏组织。MRI发现注药后随着^32P-GMS剂量的增加和时间的延长，病灶内原稍长T2信号逐渐消失，代之为等、长T2信号。结论111 MBq是经皮瘤内注射^32P-GMS治疗直径1cm实性肝癌的最佳剂量，MRI检查在评价效果和随访方面具有较高的使用价值。

The Experimental Research of the Relationship between Doses and Biological Effect with 32P-GMS by Percutaneous Intratumor Injected to Treat Liver Cancer

Objective To explore the pathological changes and the corresponding relationship between MRI findings and pathology after injected different doses of ^32P-GMS by pereutaneons intratumor, and evaluate the value of MRI in treatment. Materials and Methods The model of 24 Zealand rabbits with liver cancer were established using VX2, 37, 74, 111 and 148MBq ^32P-GMS were injected by percutaneous intratumor respectively, the changes of pathology in the tumor tissues were observed by light and electron microscope, defined the radioactivity damaging degree of tumor cell ; MRI scan of liver of every rabbit was performed before and after injected ^32p-GMS by pereutaneous intratumor. Results The correlation was presented between the dose of ^32P-GMS and the radioactivity damage of tumor cell by the pathologic results, even normal liver tissue was involved possibly. In MRI examination, slightly T2 signal in the lesions became longer follow the increment of dose and time after injected ^32p-GbtS. Conclusion 111MBq was the best radiotherapy dose for treatment of 1 cm size of liver cancer with intratumor injection of ^32P-GMS. MRI examination is useful to evaluate and follow after injected ^32P-GMS by pereutaneous intratumor.