Study On Heated ADM-lipidol Embolization Of Hepatic Tumor And Influence On Hepatic Hemodynamics And Cell Proliferation

Surgical resection remains the first choice for curative treatment of hepatocellular carcinoma (HCC), but it was limited to a small proportion of patients who had small HCC without extrahepatic metastasis and with the tumor located away from major vessels. For the majority of patients, non-surgical treatment is the only alternative. Thermotherapy is an old method for the treatment of cancers, with the progress of thermotherapy in recent years, the therapeutic effects has been improved. Heat can enhance the sensitivity of tumor cells to drugs, thereby kill the tumor cells more efficiently, so the combination of thermotherapy and interventional radiology may be able to improve the therapeutic effects of tumors such as hepatocarcinoma.Objective (1)To observe the hemodynamic change of hepatic tumor and study the relationship between embolism reaction and the changes of hemodynamics by color Doppler flow imaging in rabbit model after ADM-lipidol(60 C) embolization.(2)To evaluate and analyze the effect of ADM-lipidol(60 C) embolization influence on the proliferation of tumor cells, vascularization by the expression of PCNA, VEGF and Vffl-factor by immunohistochemistry andthe tumor microvessel density by microscop in rabbit model.(3)To study the relationship of ADM-lipidol(60'C) embolization and theexpression of VEGF by detecting the secretion of tumor VEGFmRNA andto discuss the mechanism of interventional heat chemotherapy by RT-PCRmethod in rabbit model for the first time.(4)To analyze and evaluate the therapeutic effect of ADM-lipidol(60 C)embolization and investigate the relationship between the deposition ofheat lipidol and the effect of heat embolization by CT and Ultrasonography.Mateials and Methods (1)VX2 carcinoma tissue were surgically implantedinto the left liver lobe of New Zealand white rabbits under sterile condition.1ml mixture of saline and pieces of tumor tissue was injected in each rabbit.Morphologic changes of hepatic tumors were observed by ultrasonography.The embolization was performed when the diameter of tumors grew to 2 cmin models(2) 30 New Zealand white rabbit models were divided into 3 groupsrandomly, 10 rabbits in each group. ADM-Iipidol(37 C), ADM-lipidol(60 C)and 0.9% saline were perfused respectively about 1ml via hepatic artery indifferent groups of VX2 tumor-bearing rabbit models, 5mg adriamycin ineach ADM-lipidol emulsion was injected.(3)To observe and assay the hemodynamics paremetes of VX2 tumors suchas the maximal velocity and the resisitant index of hepatic artery, thevelocity and the diameter of portal vein respectively by color Doppler flowimaging before treatment and on the 1st and 7th day after treatment.(4)To observe the volume change of tumors, the change of serum AST leveland growth curve of tumors in rabbit different model groups.(5)The morphologic change of tumors was observed by CT before and aftertherapy. The hemodynamics change of tumors was observed by digitalsubtraction angiography before and after therapy.which compared withultrasonography.(6)Pathological tissue was obtained from rabbit models at the time of killing,on the 4th and 7th day after therapy. The hepatocarcinoma tissue wasobserved by hematoxylin and eosin stained and immunohistochemistrystained respectively. The data of mean grey density as the grade ofPCNA,VEGF and VIII-factor expression were analyzed by the imageanalyzer composed of a microscopic photographic system. The change oftumor morphology and tumor microvessel density was observed bymicroscope. The VEGF mRNA expression of tumor tissue was analyzed byRT-PCR.Results (l)The changes were not significant the body weight and thetumors' volume of models before therapy. After therapy, the tumor's growthrate of ADM-lipidol(60 C)(AL60) group(0.82 0.09)was significantly lowerthan that of ADM-lipidol(37 C )(AL37) group (1.13 0.08) (P<0.05),significantly lower than that of control group(3.48 1.17)(P<0.01).(2)After heat embolization, th...