| AbstractObjective The aim of this investigation was to observe the factors effecting results of Endocare's CRYOcare surgical system and to evaluate cryotherapy combined treatment. Effect of argon-helium cryotherapy on immunity of tumor also was investigated.Methods (1) Human liver cancer cells QSG-7701 were frozen in vitro using Endocare's CRYOcare surgical system with controlled thermal parameters, such as fast or low cooling rate, subzero temperature above or below ?0C and single or double freeze-thaw cycle. (2) Mice bearing H22 hepatoma were randomly divided into five groups. (ihoup I as radical cryotherapy; group II as palliative cryotherapy; group III as injection of hyperosmotic NaCl solution; group IV as both palliative cryotherapy and injection of hyperosmotic NaC1 solution; group V as control. (3) Mice bearing H22 hepatoma were treated with argon-helium cryotherapylheat treatment (group A), surgical resection (group B) or non-treatment (group C) respectively. The proliferation index of mouse spleen cells and incidence of reinoculated tumors were observed after procedure. (4) 32 patients with irresectable hepatic carcinoma were enrolled. After treated by 1-3 course TACE, they received PHCT. The tumor size, blood levels of tumor markers, T lymphocytic subsets and NK cell of peripheral blood, 1-year survival rate and operative complications were observed after treatments.Results (1) Cryosurgerical temperature lower than ?0 0C, percentage of dead cells were 100%. Otherwise, cells were not completely destroyed between ?0 C to -40 0C. Double freeze-thaw cycle may increase percentage of dead cells. Percentage of immediately dead cells assessed with trypan blue dye after procedure were higher than cell growth inhibitive rate evaluated with MTT colorimetric assay at 48 hours after procedure. (2) Tumor growth inhibitive rate in group I, II, III and IV at the 28th day was 99.7%, 83.6%, 78.9%, 99.3% respectively. Significant inhibition of the tumor growth was seen in group I, II, III and IV as compared with group V. There was-3-significant difference in group I or group IV as compared with group II or III respectively (P<0.05), but no significant difference was seen between group I and group IV. According to 90 days after hypodermic inoculation of hepatic carcinoma cells, the median survival time in group 1, II, III, IV and V were 87.1, 63.3, 60.1, 81.1 and 52.8 days. (3) The proliferation index of mouse spleen cells in group A was significant higher than that in group B and C. When the number of reinoculated cells was ~ 1-month cancer incidences of reinoculated tumor in group A was lower than that in group B and C (P<0.05 and P<0.01) . (4) The tumor size decreased by more than 50% at 1 month after the combination treatment in 36.3% (12/33) treated by combination treatment, in 25.0% (2/8) of tumors treated by oniy TACE. The levels of AFP or CEA decreased within various extent. The level of CD44 T cell, NK cell and ratio of CD4/ CD8 increased significantly after operation (p<0.05). On the contray, the level of CD8 decreased. However operative complications were slight. 1-year survival rate is 60.0%.Conclusions (1) subzero temperature lower than -40 .C may ensure complete cell destruction. Faster coiling rate and double freeze-thaw cycle may enhance cell destruction. (2) The data suggest that cryotherapy combined with hyperosmotic NaCl solution may be a model for curative comprehensive treatment. (3) Cryotherapy and heat treatment with argon-helium may induce the anti-tumor effect. (4) Combination treatment of hepatic carcinoma with PHCT and TACE is an effective and safe method for irresectable hepatic carcinoma. |
PDF Full Text Request