Hong De-fei, Li Song-ying, Tong Li-min, Chen Bin, Peng Shu-you
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
J Zhejiang Univ Sci B. 2005 Apr;6(4):232-5. doi: 10.1631/jzus.2005.B0232.
To assess the effect of temporary occlusion of hepatic blood inflow on hepatic cancer treated with diode-laser induced thermocogation (LITT).
The carcinoma Walker-256 was implanted in 40 SD rat livers. Twelve days later, the animals were randomly divided into 4 groups. Group A received LITT alone; group B received hepatic artery temporary occlusion during LITT; group C received portal vein temporary occlusion during LITT; group D received hepatic artery and portal vein temporary occlusion during LITT. Tumors were exposed to 810 nm diode-laser light at 0.95 watts for 10 min from a scanner tip applicator placed in the tumor. At the same time, the intrahepatic temperature distribution in rats with liver tumors was measured per 2 min during thermocoagulation. Tumor control was examined immediately 7 and 14 d after thermocoagulation.
There was significant difference of intrahepatic temperature distribution in rats with liver tumors among the 4 groups (P<0.05) except when group C samples were compared with group D samples at each time point, and group B samples were compared with group C samples at 120 s (P>0.05). Light microscopic examination of the histologic section samples revealed three separate zones: regular hyperthermic coagulation necrosis zone, transition zone and reference zone. Compared with the samples in group A and group B, group C and group D samples had more clear margin among the three zones.
The hepatic blood inflow occlusion, especially portal vein hepatic blood inflow occlusion, or all hepatic blood inflow occlusion considerably increased the efficacy of LITT in the treatment of liver cancer.
评估肝血流临时阻断对二极管激光诱导热凝治疗(LITT)肝癌的影响。
将Walker-256癌植入40只SD大鼠肝脏。12天后,将动物随机分为4组。A组仅接受LITT治疗;B组在LITT期间接受肝动脉临时阻断;C组在LITT期间接受门静脉临时阻断;D组在LITT期间接受肝动脉和门静脉临时阻断。使用置于肿瘤内的扫描探头,以0.95瓦的功率将肿瘤暴露于810纳米二极管激光下10分钟。同时,在热凝过程中每2分钟测量一次肝肿瘤大鼠的肝内温度分布。热凝后7天和14天立即检查肿瘤控制情况。
除了C组样本与D组样本在每个时间点比较,以及B组样本与C组样本在120秒时比较(P>0.05)外,4组肝肿瘤大鼠的肝内温度分布存在显著差异(P<0.05)。组织切片样本的光镜检查显示三个不同区域:规则的高温凝固坏死区、过渡区和对照区。与A组和B组样本相比,C组和D组样本在这三个区域之间的边界更清晰。
肝血流阻断,尤其是门静脉肝血流阻断,或全肝血流阻断,可显著提高LITT治疗肝癌的疗效。