自体CD133+细胞增强门静脉栓塞的效果。

Autologous CD133+ cells augment the effect of portal embolization.

作者信息

Canepa M C, Quaretti P, Perotti C, Vercelli A, Rademacher J, Peloso A, Barbieri L, Franchi E, Briani L, Gaspari A, Brugnatelli S, Pedrazzoli P, Dionigi P, Maestri M

机构信息

Department of General Surgery I, University of Pavia, Pavia, Italy.

出版信息

Minerva Chir. 2013 Apr;68(2):163-8.

PMID:23612229

Abstract

AIM

The standard to treat liver tumors is a resection. When the future liver remnant (FLRV) is below 30% (healthy livers) or 40% (cirrhotic livers or previous chemotherapy), surgery carries the risk of severe complications. Portal vein embolization (PVE) gained a worldwide diffusion as a tool to augment the FLRV. Cell therapies are recent players at the frontiers of medicine. This study presents a clinical experience to evaluate the synergistic effect of combined PVE and autologous CD133+ cells coadministration.

METHODS

Sixteen patients have been enrolled in the study up today. Inclusion criteria were: primary or metastatic liver malignancy with a FLRV<30% or 40%. A baseline volumetric CT-scan was obtained. CD34+ were mobilized to the blood stream by G-CSF administration and collected by immunomagnetic separation. Simultaneously with PVE, cells were administered to the non occluded liver segments. Follow-up CT scans were taken at 30th post treatment day.

RESULTS

The patients (N.=6) showed an increased volume gain (Mann-Whitney test P<0.001, two sided) compared to a set of cases whose treatment was PVE only (N.=10).

DISCUSSION

The use of autologous stem cells as an augmenter of liver regeneration has a clinical potential to improve the resectability of liver tumors.

摘要

目的

治疗肝肿瘤的标准方法是手术切除。当未来肝残余量（FLRV）低于30%（健康肝脏）或40%（肝硬化肝脏或既往接受过化疗的肝脏）时，手术会带来严重并发症的风险。门静脉栓塞术（PVE）作为增加FLRV的一种手段已在全球广泛应用。细胞疗法是医学前沿领域的新兴手段。本研究展示了一项临床经验，以评估联合应用PVE和自体CD133+细胞的协同效应。

方法

截至目前，已有16例患者纳入本研究。纳入标准为：原发性或转移性肝恶性肿瘤，FLRV<30%或40%。获取基线容积CT扫描图像。通过给予粒细胞集落刺激因子（G-CSF）将CD34+细胞动员至血流中，并通过免疫磁珠分离法进行采集。在进行PVE的同时，将细胞注入未栓塞的肝段。在治疗后第30天进行随访CT扫描。