Ismail Alaa, AlDorry Ahmed, Shaker Mohammed, Elwekeel Reda, Mokbel Khaled, Zakaria Doaa, Meshaal Anas, Eldeen Firas Zahr, Selim Abdulhafez
Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Gastrointest Cancer. 2011 Mar;42(1):11-9. doi: 10.1007/s12029-010-9218-0.
The discovery of the pluripotent stem cells made the prospect of cell therapy and tissue regeneration a clinical reality, especially with the evidence of contribution of the stem cells of bone marrow origin in hepatic regeneration. Infusion of bone marrow stem cells before trans-arterial chemoembolization may help to increase liver volume and consequently increase hepatic reserve in patients with HCC, and this may improve the outcome of this procedure.
Four Child B class patients with unresectable hepatocellular carcinoma treated by transarterial chemoembolization were injected with autologous bone marrow mononuclear layer containing stem cell in the hepatic artery feeding the contralateral lobe of the liver in the same session, follow-up of the patients was done by doing liver profile and CT liver volumetry before the surgery and 3 months later.
We observed that patients receiving stem cell therapy simultaneously with TACE had shown a significant improvement in biological and volumetric parameters of liver function compared to those historically reported of patients receiving TACE only who usually shows deterioration of liver parameters.
BMC infusion into the hepatic artery synchronized with TACE for patients with chronic liver disease complicated with HCC is safe, feasible, and demonstrated an improvement in both biological and radiological volumetric parameters.
多能干细胞的发现使细胞治疗和组织再生的前景成为临床现实,尤其是有证据表明骨髓来源的干细胞对肝脏再生有贡献。在经动脉化疗栓塞术前输注骨髓干细胞可能有助于增加肝癌患者的肝脏体积,从而增加肝脏储备,这可能改善该手术的效果。
4例接受经动脉化疗栓塞治疗的Child B级不可切除肝细胞癌患者,在同一次手术中,于肝动脉内向肝脏对侧叶供血处注射含干细胞的自体骨髓单个核层,术前及术后3个月通过肝功能检查和肝脏CT容积测量对患者进行随访。
我们观察到,与仅接受经动脉化疗栓塞术(通常表现为肝功能参数恶化)的患者的历史报告相比,同时接受干细胞治疗和经动脉化疗栓塞术的患者在肝功能的生物学和容积参数方面有显著改善。
对于慢性肝病合并肝癌患者,在经动脉化疗栓塞术的同时向肝动脉内输注骨髓干细胞是安全、可行的,并且在生物学和放射学容积参数方面均有改善。