低浓度α-氰基丙烯酸正丁酯栓塞兔VX2肝脏肿瘤的实验研究

目的 观察低浓度α-氰基丙烯酸正丁酯(NBCA)经肝动脉栓塞兔肝脏肿瘤的可行性、安全性和有效性.方法 24只实验兔,开腹在肝脏左叶种植瘤细胞建立VX2肝脏肿瘤模型,建模后14 d CT扫描测量肿瘤大小,并用数字表法随机等分为3组,后通过肝动脉对肿瘤进行栓塞.A组为空白对照组,B组为超液化碘油组,C组为2.5% NBCA组.肝脏损害通过检测血清丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)评价.栓塞术后第7天再次通过CT扫描测量肿瘤体积,肿瘤生长比率(术后7 d肿瘤体积与术前肿瘤体积之比);并于栓塞治疗后记录各组实验兔的生存时间.对ALT和AST采用重复测量方差分析,肿瘤生长比率和生存时间采用单因素方差分析比较.结果 所有动物模型均成功建立并插管治疗.A、B、C各组实验兔在栓塞前后不同时间ALT和AST均值的差异有统计学意义(ALT的 F值分别为10.508、16.443、19.828,AST 的F值分别为23.696、23.334、15.594,P值均＜0.05).栓塞治疗后第4天A、B、C组ALT水平分别为(49.4±13.5)、(115.2±48.8)、(124.7±49.4)U/L,AST水平分别为(52.3±12.0)、(128.3±50.1)、(137.0±66.9)U/L,B组和C组血清ALT和AST水平均较A组高(P值均＜0.05).B、C组术后第4天ALT、AST均较术前明显升高(P值均＜0.05).各组ALT和AST术后第7天和术前相比,差异均无统计学意义.术后第7天肝脏肿瘤生长比率在3组之间差异有统计学意义(F=110.865,P=0.000);C 组的肿瘤生长比率为(0.839±0.144)%,显著低于A 组的(2.978±0.547)%(P=0.000),与B组的(0.871±0.073)%相比差异无统计学意义(P=0.845).栓塞治疗后C组生存期为(38.9±4.0) d,明显长于A组的(32.1±3.1) d(P=0.006);与B组的(36.9±4.8)d相比差异无统计学意义(P=0.366).结论 经肝动脉栓塞低浓度NBCA治疗兔VX2肝脏肿瘤是一种可行的、安全的治疗方法,为治疗肝脏肿瘤提供一种新的选择,可能有潜在的临床推广价值.

Abstract：

Objective To investigate the feasibility, safety and efficacy of transarterial embolization with low concentration of n-butyl cyanoacrylate(NBCA) in rabbit VX2 liver tumor models. MethodsTwenty-four rabbits were implanted with VX2 hepatic tumors into the left hepatic lobes, and were scanned with CT to measure the volume of the tumor after 14 days. They were randomly divided into three groups with 8 rabbits assigned to each group. Transarterial embolization was conducted with physiological saline in control group A, with pure Lipiodol in group B, with 2.5% NBCA in group C. Hepatic toxicity was evaluated by blood biochemical analysis of the plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST). One week later, the volumes of the tumors were measured by CT again. Tumor growth rate was the ratio of tumor's volume at 7th day after embolization to the tumors' volume before embolization. The survival periods of the rabbits of the three groups after treatment were also recorded. The data of ALT and AST mean values from each group were analyzed with repeated measurement analysis of variance (ANOVA). Tumor growth rates and survival periods were analyzed by using one-way ANOVA. Results All animal models were successfully established and underwent interventional catheterization. Both ALT and AST mean values of the rabbits in group A, B and C at each time point before and after embolization were significantly different (ALT F=10.508, 16.443, 19.828, respectively; AST F=23.696, 23.334, 15.594, respectively)(P＜0.05). ALT in group A, B, C were (49.4±13.5), (115.2±48.8), (124.7±49.4)U/L, while AST in group A, B, C were (52.3±12.0), (128.3±50.1), (137.0±66.9)U/L 4 days after embolization. The ALT and AST mean values were significantly elevated 4 days after embolization in group B and group C compared with those before embolization and those of group A 4 days after treatment(P＜0.05). However, the ALT and AST mean values showed no statistically significant difference in all the groups before embolization and 7 days after embolization. On the other hand, the growth rates of the tumors differed significantly among the three groups(F=110.865, P=0.000). The group C showed significantly lower tumor growth rate (0.839±0.144)% than the group A(2.978±0.547)%(P=0.000), but no significantly different tumor growth rate compared with group B(0.871±0.0725)%( P=0.845). Consequently, the survival period of the animals in group C(38.9±4.0) days was significantly longer than that in group A(32.1±3.1)days (P=0.006), while it was not significantly different from that in group B(36.9±4.8)days(P=0.366). ConclusionsTransarterial embolization with low concentration of NBCA was feasible and safe. It could be a new option of treatment for HCC and might have potential further clinical value.

Transarterial embolization with low concentration of n-butyl cyanoacrylate in VX2 hepatic tumor rabbit: an experimental study

Objective To investigate the feasibility, safety and efficacy of transarterial embolization with low concentration of n-butyl cyanoacrylate(NBCA) in rabbit VX2 liver tumor models. MethodsTwenty-four rabbits were implanted with VX2 hepatic tumors into the left hepatic lobes, and were scanned with CT to measure the volume of the tumor after 14 days. They were randomly divided into three groups with 8 rabbits assigned to each group. Transarterial embolization was conducted with physiological saline in control group A, with pure Lipiodol in group B, with 2.5% NBCA in group C. Hepatic toxicity was evaluated by blood biochemical analysis of the plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST). One week later, the volumes of the tumors were measured by CT again. Tumor growth rate was the ratio of tumor's volume at 7th day after embolization to the tumors' volume before embolization. The survival periods of the rabbits of the three groups after treatment were also recorded. The data of ALT and AST mean values from each group were analyzed with repeated measurement analysis of variance (ANOVA). Tumor growth rates and survival periods were analyzed by using one-way ANOVA. Results All animal models were successfully established and underwent interventional catheterization. Both ALT and AST mean values of the rabbits in group A, B and C at each time point before and after embolization were significantly different (ALT F=10.508, 16.443, 19.828, respectively; AST F=23.696, 23.334, 15.594, respectively)(P＜0.05). ALT in group A, B, C were (49.4±13.5), (115.2±48.8), (124.7±49.4)U/L, while AST in group A, B, C were (52.3±12.0), (128.3±50.1), (137.0±66.9)U/L 4 days after embolization. The ALT and AST mean values were significantly elevated 4 days after embolization in group B and group C compared with those before embolization and those of group A 4 days after treatment(P＜0.05). However, the ALT and AST mean values showed no statistically significant difference in all the groups before embolization and 7 days after embolization. On the other hand, the growth rates of the tumors differed significantly among the three groups(F=110.865, P=0.000). The group C showed significantly lower tumor growth rate (0.839±0.144)% than the group A(2.978±0.547)%(P=0.000), but no significantly different tumor growth rate compared with group B(0.871±0.0725)%( P=0.845). Consequently, the survival period of the animals in group C(38.9±4.0) days was significantly longer than that in group A(32.1±3.1)days (P=0.006), while it was not significantly different from that in group B(36.9±4.8)days(P=0.366). ConclusionsTransarterial embolization with low concentration of NBCA was feasible and safe. It could be a new option of treatment for HCC and might have potential further clinical value.