Colon & Rectum Surgery, St. Luke's Roosevelt Hospital Center, 432 West, 58th Street, Room 517, New York, NY 10019, USA.
Surg Endosc. 2012 Jul;26(7):1856-64. doi: 10.1007/s00464-011-2114-2. Epub 2012 Jan 19.
Perioperative anticancer therapy that does not impair wound healing is needed to counter the persistent proangiogenic plasma compositional changes that occur after colorectal resection. Polyphenon E (PolyE), a green tea derivative (main component EGCG), and Siliphos (main component silibinin), from the milk thistle plant, both have antitumor effects. This study assessed the impact of PolyE/Siliphos (PES) on wound healing and the growth of CT-26 colon cancer in several murine models.
One wound healing and three tumor studies were performed. Tumor Study (TS)1 assessed the impact of PES on subcutaneous tumor growth, whereas TS2 assessed PES's impact on subcutaneous growth when given pre- and post-CO(2) pneumoperitoneum (pneumo), sham laparotomy, or anesthesia alone. TS3 determined the ability of PES to limit hepatic metastases (mets) after portal venous injection of tumor cells. In the final study, laparotomy and gastrotomy wound healing were assessed several ways. BALB/c mice were used for all studies. The drugs were given via drinking water (PolyE) and gavage (Siliphos), daily, for 7-9 days preprocedure and for 7-21 days postoperatively. Tumor mass, number/size of hepatic mets, and proliferation and apoptosis rates were assessed. The abdominal breaking strength and energy to failure were measured postmortem as was gastric bursting pressures.
PES significantly inhibited subcutaneous growth in the nonoperative setting. PES also significantly decreased the number/size of liver mets when given perioperatively. Abdominal wound breaking strength, energy to wound failure, and collagen content were not altered by PES; gastrotomy bursting strength also was not affected by PES. Neither drug alone had a significant impact on tumor growth.
The PES combination inhibited subcutaneous and hepatic tumor growth yet did not impair wound healing. PES holds promise as a perioperative anticancer therapy.
需要进行不会影响伤口愈合的围手术期抗癌治疗,以对抗结直肠切除术后持续存在的促血管生成的血浆成分变化。绿茶提取物(主要成分表没食子儿茶素没食子酸酯,简称 EGCG)和水飞蓟素(主要成分水飞蓟宾)来自奶蓟草植物,都具有抗肿瘤作用。本研究评估了多酚 E/水飞蓟素(PES)对几种小鼠模型中伤口愈合和 CT-26 结肠癌生长的影响。
进行了一项伤口愈合和三项肿瘤研究。肿瘤研究 1(TS1)评估了 PES 对皮下肿瘤生长的影响,而肿瘤研究 2(TS2)评估了 PES 在 CO₂ 气腹前和后、假手术或单独麻醉时对皮下生长的影响。肿瘤研究 3(TS3)确定了 PES 限制门静脉注射肿瘤细胞后肝转移(mets)的能力。在最后一项研究中,通过多种方式评估了剖腹术和胃切开术的伤口愈合情况。所有研究均使用 BALB/c 小鼠。药物通过饮用水(多酚 E)和灌胃(水飞蓟素)给予,每天一次,术前 7-9 天,术后 7-21 天。评估肿瘤质量、肝 mets 的数量/大小以及增殖和凋亡率。死后测量腹部断裂强度和失效能量,以及胃爆裂压。
PES 在非手术环境中显著抑制皮下生长。PES 还显著减少了围手术期给予时肝 mets 的数量/大小。PES 不改变腹部伤口断裂强度、伤口失效能量和胶原含量;PES 也不影响胃切开术爆裂强度。单独使用这两种药物都没有显著影响肿瘤生长。
PES 联合抑制皮下和肝肿瘤生长,但不影响伤口愈合。PES 有望成为一种围手术期抗癌治疗方法。