Song Dongda, Hu Minggen, Guo Weichang
Department of Surgical Oncology, Chinese PLA General Hospital, Beijing, China (mainland).
Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland).
Med Sci Monit. 2017 Mar 27;23:1471-1476. doi: 10.12659/msm.899941.
BACKGROUND The concepts of sequential transcatheter arterial chemoembolization (TACE) and portal venous embolization (PVE) were proposed to prevent the detrimental tumor growth-inducing effect of PVE and to facilitate growth of further future liver remnant (FLR). This study aimed to investigate the effect of sequential TACE and PVE on liver damage and the therapeutic effect in a rabbit VX2 liver tumor model. MATERIAL AND METHODS Rabbits bearing VX2 liver tumors were randomly divided into TACE+PVE, TACE, PVE, and Sham groups. Plasma levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), and alkaline phosphatase (ALP) at 6 h, 24 h, 3 days, and 7 days were measured by ELISA assay. Tumor diameter on day 7 was measured and the tumor sections with cleaved caspase-3 was stained and observed. RESULTS Plasma ALT, AST, and ALP levels were significantly increased at the first hours after the interventions. The TACE group had higher increases than the TACE+PVE and PVE alone groups. ALT, AST, and ALP levels decreased on day 7 and presented a trend to return to the baseline level. The TACE+PVE group showed stronger tumor-inhibiting effect than the TACE and PVE alone groups and also induced the highest level of tumor cell apoptosis. CONCLUSIONS The liver damage caused by TACE+PVE is mild and recoverable. TACE+PVE showed stronger tumor-inhibiting effect than in the TACE and PVE group and also induced the highest level of tumor cell apoptosis.
序贯性经动脉化疗栓塞术(TACE)和门静脉栓塞术(PVE)的概念被提出,以预防PVE对肿瘤生长的有害诱导作用,并促进未来剩余肝脏(FLR)的生长。本研究旨在探讨序贯性TACE和PVE对兔VX2肝肿瘤模型肝损伤的影响及治疗效果。
将荷VX2肝肿瘤的兔随机分为TACE+PVE组、TACE组、PVE组和假手术组。采用酶联免疫吸附测定法(ELISA)检测干预后6小时、24小时、3天和7天血浆中天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)和碱性磷酸酶(ALP)水平。测量第7天的肿瘤直径,并对肿瘤切片进行半胱天冬酶-3(cleaved caspase-3)染色观察。
干预后最初几小时血浆ALT、AST和ALP水平显著升高。TACE组升高幅度高于TACE+PVE组和单纯PVE组。ALT、AST和ALP水平在第7天下降,并呈现出恢复至基线水平的趋势。TACE+PVE组显示出比TACE组和单纯PVE组更强的肿瘤抑制作用,且诱导的肿瘤细胞凋亡水平最高。
TACE+PVE引起的肝损伤较轻且可恢复。TACE+PVE显示出比TACE组和PVE组更强的肿瘤抑制作用,且诱导的肿瘤细胞凋亡水平最高。