Bano Nusrat, Najam Rahila
Department of Pharmacology, King Saud Bin Abdulaziz University For Health Sciences, Jeddah, Saudi Arabia.
Department of Pharmacology, University of Karachi, Karachi, Saudi Arabia.
Arch Med Sci. 2019 Jul;15(4):1092-1103. doi: 10.5114/aoms.2019.86064. Epub 2019 Jun 20.
Chemotherapy-induced hepatotoxicity in cancer patients often results in cessation of therapy and prevents completion of the treatment plan. The entire pathological description and comparison of hepatic damage induced by oxaliplatin or cisplatin in combination with 5-fluorouracil (5-FU) is not adequately reported. This study reports histopathological assessment of hepatotoxicity of a non-tumor bearing organ in rats treated with 5-FU, oxaliplatin and cisplatin (CDDP).
Changes in hepatic biochemical profile of 36 albino Wistar rats equally divided into different treatment groups with cisplatin, oxaliplatin, 5-FU, cisplatin plus 5-FU and oxaliplatin plus 5-FU were compared with a group of rats treated with normal saline (control group). At the end of treatments, hepatic tissues were taken for blinded histopathological assessment by light microscopy.
Serum glutamate pyruvate transaminase and serum glutamic-oxaloacetic transaminase levels were disrupted in rats treated with 5-FU alone and in combination with cisplatin or oxaliplatin. Hepatocellular injuries, e.g. sinusoidal dilatation, venular fibrosis and centrilobular vein injury induced by oxaliplatin were intensified in treatment groups also receiving 5-FU, manifested as massive architectural distortion, periportal fibrosis, hepatic cord degeneration and cystic lesions with demarcated margins. Hepatocellular degenerative sequence and abnormally dilated central hepatic vein was shown in the cisplatin plus 5-FU treatment group with hemorrhage and blood filled sinusoids.
Oxaliplatin-associated cystic lesions were intensified in rats treated with a combination of 5-FU and oxaliplatin.
癌症患者化疗引起的肝毒性常导致治疗中断,无法完成治疗计划。奥沙利铂或顺铂联合5-氟尿嘧啶(5-FU)所致肝损伤的完整病理描述及比较尚未得到充分报道。本研究报告了用5-FU、奥沙利铂和顺铂(CDDP)治疗的大鼠非肿瘤器官肝毒性的组织病理学评估。
将36只白化Wistar大鼠平均分为不同治疗组,分别用顺铂、奥沙利铂、5-FU、顺铂加5-FU和奥沙利铂加5-FU进行治疗,将其肝脏生化指标变化与一组用生理盐水治疗的大鼠(对照组)进行比较。治疗结束时,取肝脏组织进行盲法组织病理学评估,采用光学显微镜观察。
单独使用5-FU以及5-FU与顺铂或奥沙利铂联合使用的大鼠血清谷丙转氨酶和血清谷草转氨酶水平均受到干扰。在用奥沙利铂诱导肝细胞损伤(如肝血窦扩张、小静脉纤维化和中央小叶静脉损伤)的治疗组中,若同时给予5-FU,这些损伤会加剧,表现为大量结构扭曲、汇管区周围纤维化、肝索变性以及边缘清晰的囊性病变。顺铂加5-FU治疗组出现肝细胞变性序列和肝中央静脉异常扩张,并伴有出血和血窦充血。
在接受5-FU和奥沙利铂联合治疗的大鼠中,奥沙利铂相关的囊性病变会加剧。