Study Of Doppler Sonography On Rabbit Hepatic Implantation Tumor After Transcatheter Arterial Chemoembolization With Endostatin And Adm-Lipiodol

Objective To investigate the effect of TACE with endostatin and Lipiodol on growth,angiogenesis,and MVD expression of rabbit VX2 hepatic tumor by two-dimention sonography,color Doppler flow(power) imaging and immunohistochemistry method.Material and methods 1.Thirty-two New Zealand white healthy rabbits,2 pieces of 1mm~3 fragment of VX2 carcinoma were inoculated into the sub-capsule of the left or right hepatic central lobe via laparotomy.Morphologic changes of hepatic tumors were observed by ultrasonography.The embolization was performed when the diameter of tumors grew to about 1-2cm in models.2.30 New Zealand white rabbit models were divided into 3 groups randomly,10 rabbits in each group. ADM-lipiodol,endostatin(2mg/kg) combined with ADM-lipiodol and 0.9%saline about 10ml were perfused respectively via hepatic artery in different groups of VX2 tumor-bearing rabbit models,2mg/kg adriamycin in each 0.2ml/kg lipiodol emulsion was injected.3.Used 2-D ultrasound to observe the volume change of tumors, calculate the rate of growth and write the growth curve of tumors in rabbit different model groups.Taking CDPI to observe the characteristics of blood flow in tumors. To observe and assay the disposition of blood and the hemodynamics parameters of VX2 tumors such as the maximal velocity and the resistant index of hepatic artery, the velocity of portal vein respectively by color Doppler flow imaging before treatment and on the 4th and 7th day after treatment.4.Pathological tissue was obtained from rabbit models at the time of killing,on the 7th day after therapy.The hepatocarcinoma tissue was observed by naked eye,hematoxylin and eosin stained and immunohistochemistry stained respectively.Measured the diameter of tumor. The data of MVD expression were calculated by two person.The change of tumor morphology and tumor microvessel density was observed by microscope.Compared the correlation of blood flow grade and MVD.Results 1.The changes were not significant the tumors' volume of models before therapy.After therapy,the tumors' growth rate of endostatin combined with ADM-lipiodol group(-20.4±36.1) was significantly lower than that of control group(269.86±148.9)(P＜0.01).2.Observed by Doppler ultrasonography,the maximal velocity of hepatic artery in group endostatin-AL(26.17±7.94) was lower than that of control group(41.16±6.65)(P＜0.05),not significant compared with that of group AL(32.72±5.31)(P＞0.05).The resistant index of hepatic artery in group endostatin-AL(0.45±0.10) was higher than that of control group(0.35±0.06) (P＜0.05),the change of resistant index of hepatic artery in group AL(0.37±0.07) was not significant compared with that of group endostatin-AL.There was not significant change in the velocities of portal vein in rabbit model groups(P＞0.05).3. Observed by CDFI and CDPI,the blood flow signals para-tumors and intra-tumors significantly were richer before perfusion,became less(3/10) and even disappearing completely(7/10) after embolization.The tumor blood-flow block were more obviously in the group of endostatin-AL than that of other groups.4.The tumors' MVD of endostatin-AL group(57.00±13.26) was significantly lower than that of AL group(84.22±16.45) and control group(80.00±17.14)(P＜0.01).The cases of blood flow grade 0,Ⅰ,Ⅱ,Ⅲis 12,8,6,4 respectively,the corresponding of MVD was 75.6±16.77,76.00±29.85,68.4±12.48 and 80.2±21.49,but there was no statistically significant difference(P＞0.05).Conclusion 1.TACE can inhibit the growth of the implanted VX2 tumor,but maybe have no effect on metastasis;TACE combined with endostatin treatment not only can inhibit the growth of the implanted tumor but also can inhibit its metastasis.2.Color Doppler sonography is a effective and convenient imaging method for observation the effect of transcatheter arterial chemoembolization on hepatocellular carcinoma.