胰腺区域性动脉灌注治疗胰腺癌的实验研究

目的：为了探讨进展期胰腺癌介入治疗的作用机制。方法：选用10条毕格犬随机分实验组和对照组,每组5条,实验组在数字减影动脉造影术（DSA）引导下分别置管至腹腔动脉干和肠系膜上动脉并注射吉西他滨（45mg/kg),对照组经外周静脉注射吉西他演（45mg/kg),给药后采集外周静脉血,胰腺,胰周,心,肺和肝肾等组织,测定吉西他滨的血药浓度和组织内匀浆浓度,并观察组织病理改变。结果：给药2,4,8,h后,实验组吉西他滨西浓度明显高于对照组。实验组经剂量校正后的曲线下面积也明显高于对照组;经剂量校正后的药物在故事片腐朽 内的平均滞留时间实验组比对照组明显延长。给药4,8h后,实验组胰腺组织内药物浓度明显高于对照组,病理检查提示;对照组犬肾小球毛细血管及肾小管内见大量红细胞,肺毛细血管及心肌明显瘀血,出血,而实验组无明显病理改变,实验组胰周脂肪中见大量中性白细胞浸润,出血及纤维素样渗出,对照组无此病理改变。结论：区域性动脉灌注能使吉西他滨在胰腺内浓度明显提高,体内滞留时间明显延长,对全身其他重要脏器的毒作用较小,适用于胰腺癌的介入治疗。

Regional intra-arterial infusion chemotherapy for pancreatic cancer: an experimental study

Objective To verify the feasibility of regional intra arterial infusion chemotherapy with gemcitabine for the treatment of locally advanced pancreatic cancer. Methods 10 Beagle dogs were divided into two groups: the experimental group and the control group. In the experimental group, gemcitabine(45 mg/kg) were infused via a transfemorally placed catheter into the celiac axis and superior mesenteric artery. IAC was given over 30 min with the help of DSA. In the control group, chemotherapy was performed via peripheral veins with the same dosage as the experimental group. Blood samples, heart, lung, liver, kidney, pancreas and parapancreatic tissues were obtained for drug concentration determination and pathological examination. Results The serum concentration of experimental group were significantly higher than those of the control group 2 hr, 4 hr and 8 hr after treatment( P <0.05). Area under curve after dosage based calibration in experimental group was much higher than that in control group( P <0.05). The mean retention time of the drug in the animal body was significantly longer in experimental group than in control group. Pancreatic gemcitabine titer in experimental group was significantly higher than that in control group 4 hr and 8 hr after drug administration. There were a large number of red blood cells in the renal glomerulus and tubules, congestion and hemorrahge in the pulmonary capillaries and myocardium in the control group according to pathological examinations. However, infiltration of neutrophilic white blood cells, hemorrahge and fibrinous exudation were present in parapancreatic tissues which were absent in the group. Conclusion Regional intra arterial infusion chemotherapy with gemcitabine could increase serum and pancreatic drug concentration, prolongs retention time of the drug in the animal body, and is feasible in the treatment of pancreatic cancer.