术前经动脉化疗栓塞对肝癌细胞增殖的影响

目的　评价术前经导管动脉化疗栓塞 (transcatheterarterialchemoembolization ,TACE)对肝细胞癌细胞增殖的影响。方法　经手术病理证实的肝细胞癌 136例 ,其中行 1～ 5次TACE后Ⅱ期手术切除 79例 (TACE组 ) ,按治疗方式不同分 4组 ,A组 11例 ,仅灌注化疗药物 ,治疗 1～ 4次 ;B组 33例 ,化疗药加碘化油栓塞 ,治疗 1～ 5次 ;C组 2 3例 ,化疗药加碘化油加明胶海绵颗粒栓塞 ,治疗 1～ 3次 ;D组 12例 ,化疗药加碘化油、无水乙醇、明胶海绵颗粒栓塞 ,治疗 1～ 3次。单纯手术 5 7例 (非TACE组 ) ,用免疫组化检测各标本Ki 6 7和增殖细胞核抗原 (PCNA)蛋白表达。结果　TACE组的C组和D组较非TACE组Ki 6 7和PCNA蛋白表达显著降低 (P <0 .0 5 )。A组和B组较非TACE组Ki 6 7和PC NA蛋白表达显著增高 (P <0 .0 5 )。结论　多材料联合栓塞TACE后肝癌细胞的增殖活性受抑制 ,而单材料栓塞、单纯化疗后肝癌细胞的增殖活性得到增强。

Effect of preoperative transcatheter arterial chemoembolization on proliferation of hepatocellular carcinoma cells

Objective To evaluate the effect of preoperative transcatheter arterial chemoembolization on proliferation of hepatocellular carcinoma cells. Methods A total of 136 patients with hepatocellular(HCC) underwent liver resection and pathologic confirmation. One to five courses of TACE prior to liver resection were performed in 79 patients (TACE group); with one to four courses of chemotherapy alone were performed in 11 patients (Group A); one to five courses of chemotherapy combined with iodized oil were performed in 33 patients (Group B); one to three courses of chemotherapy combined with iodized oil and gelation sponge were performed in 23 patients (Group C); one to three courses of chemotherapy combined with iodized oil, ethanol and gelatin sponge were performed in 12 patients (Group D). The other 57 patients only received liver resection (non-TACE group). The expressions of Ki-67 and proliferating cell nuclear antgen(PCNA) protein were detected by immunohistochemical method. Results The Ki-67 and PCNA protein expressions were significantly lower in Groups C and D than those in the non-TACE group (P<0.05). The Ki-67 and PCNA protein expressions were significantly higher in Groups A and B than those in the non-TACE group (P<0.05). Conclusions Preoperative multimaterial TACE suppressed the proliferation of HCC cells, while single material embolization and chemotherapy alone enhanced it.