Department of Medical Ultrasonics, Division of Interventional Ultrasound, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Medical Ultrasonics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int J Hyperthermia. 2021;38(1):1394-1400. doi: 10.1080/02656736.2021.1977857.
To discuss the possible reasons why percutaneous intratumoral ethanol injection (PEI) combined with radiofrequency ablation (RFA) to treat hepatocellular carcinoma (HCC) reduced the recurrence and metastasis compared with RFA alone.
Forty VX2 tumor-bearing rabbits were randomly divided into four groups ( = 10): the PEI, RFA, PEI-RFA, and control groups. Five rabbits from each group were sacrificed on the 3rd and 7th days after ablation. The number of metastatic tumors in the lung was counted. The ablation volume was measured, and residual tumor specimens were prepared for hematoxylin and eosin staining and caspase-3, Ki-67, and VEGF immunohistochemical staining.
The volume of ablation in the PEI-RFA group was significantly larger than that in the RFA and PEI groups ( < 0.05). However, no significant differences in the number of lung metastases after ablation were observed among the groups ( > 0.05). The number of microthrombi in the PEI-RFA group was greater than that in the control and RFA groups ( < 0.001 and < 0.05). The Ki-67 labeling index (LI) and H-score of VEGF in the PEI-RFA group were lower than those in the RFA group, while the H-score of caspase-3 was higher than that in the RFA group on the 7th day after ablation ( < 0.05).
PEI occluded blood vessels by inducing microthrombi formation, and thereby reducing heat dissipation and increasing the effect of RFA. More importantly, in comparison with an incomplete RFA, PEI-RFA inhibited the increase in the Ki-67 and VEGF expression levels and the decrease in the caspase-3 expression level to happen at some extent and therefore improved the prognosis.
探讨经皮瘤内乙醇注射（PEI）联合射频消融（RFA）治疗肝细胞癌（HCC）较单纯 RFA 降低复发转移率的可能原因。
将 40 只 VX2 荷瘤兔随机分为 4 组（每组 10 只）：PEI 组、RFA 组、PEI-RFA 组和对照组。每组各有 5 只兔分别于消融后第 3、7 天处死，计数肺转移瘤数量，测量消融体积，制备残余肿瘤标本行苏木精-伊红（HE）染色及 caspase-3、Ki-67、VEGF 免疫组化染色。
PEI-RFA 组的消融体积明显大于 RFA 组和 PEI 组（P＜0.05），但消融后各组间肺转移瘤数量无显著差异（P＞0.05）。PEI-RFA 组微血栓数量多于对照组和 RFA 组（P＜0.001 和 P＜0.05）。PEI-RFA 组消融后第 7 天 Ki-67 标记指数（LI）和 VEGF 的 H 评分低于 RFA 组，而 caspase-3 的 H 评分高于 RFA 组（P＜0.05）。
PEI 通过诱导微血栓形成闭塞血管，减少热量散失，增强 RFA 效果。更重要的是，与不完全 RFA 相比，PEI-RFA 在一定程度上抑制了 Ki-67 和 VEGF 表达水平的升高以及 caspase-3 表达水平的降低，从而改善了预后。
