| Objective1.To explore the feasibility of establishing better liver cancer models of VX2 rabbit with percutaneous puncture implantation guided by enhanced CT.2.To study best safe perfusion temperature with the liver thermometric test in healthy rabbits after TATC-IVCBO(transhepatic arterial thermochemotherapy with inferior vena cava balloon occlusion,TATC-IVCBO).By comparing routine TACE and TATCE-IVCBO for treatment of rabbit VX2 liver tumor,to explore TATCE-IVCBO's advantages and limitations,and provide reference and theoretical basis for the clinical application of TATCE-IVCBO for treatment of hepatocellular carcinoma.Method1.32 healthy New Zealand white rabbits were randomly divided into group A and group B(n = 16).In group A and in group B.The rabbit VX2 liver tumor models were established respectively by two implantation methods through percutaneous puncture under enhanced CT-guided and direct vision with paunch operation.The time of operation?tumor formation rate,postoperative complications and the imaging and pathological features of the two methods were studied.2.The temperature measuring experiment was divided into two steps.The first step,20 healthy New Zealand white rabbits were randomly divided into four groups(50?,55?,60?and 65?group,n = 5),before and after the balloon occlusion of the inferior vena cava,rabbits liver was infused in sequence with 10 ml normal saline(1 ml per minute)of 50?,55?,60?,65? by hepatic artery catheterization,under opening vision,the temperature of the central and marginal area in left lobe of liver were monitored by thermocouple puncture needle.The second step,the above-mentioned experiment methods were also used for transcatheter arterial thermochemotherapy with 20 healthy New Zealand white rabbits,under the same conditions,e 10 ml mixture of normal saline and 5mg cisplatin were injected.After operation,liver function of d1,d3,d7,d14 and pathological examinations after 3,7days were taken.3.Using the method A,20 rabbits with VX2 tumor size of 1.5-2cm were randomly divided into two groups(n = 10,study group and control group).Two methods for treatment of rabbit vx2 hepatic tumor: method 1 was TATCE-TIVCO(study group),2.2F microcatheter,were superselective inserted left hepatic artery via femoral artery puncture after the occlusion of the inferior vena cava,the 10 ml mixture of saline and 5mg cisplatin before 60 degree emulsion of 2mg pirarubicin and 1ml iodized oil was injected with constant temperature(the optimal perfusion temperature with 60?).method 2 was routine TACE(control group),the temperature of chemotherapeutic drug and iodized oil emulsion was 25?,and the treatment procedure was performed without IVC occlusion.After operation,liver function of the two groups of d1,d3,d5 and d7 were observed,and tumor volume was measured by CT scan the on d7.Result1.In group A and group B,the operation time were 15.0±0.11 mins and 26.2±0.11 mins,and the rate of tumor formation 93.7% and100%,the postoperative infection rate was 0 and 12.50% respectively;There was no serious complication in group A,and 2 rabbits died of incision infection in group B.The rate of tumor formation and the tumor size had no significant difference between the two groups(P> 0.05),the operative time and postoperative complications had significant difference between the two groups(P< 0.05).Group A,the mean tumor size after 2 weeks were(1.32 ±0.10)cm,group B was(1.41±0.11)cm.On enhanced CT scan after 2 weeks and 3 weeks,the VX2 tumor lesion showed as aringlike-enhanced area,four weeks later,the lesion increased significantly and with obvious necrosis region in the tumor,which were consistent with their pathology examination.2.In the 60?group,with inferior vena cava balloon occlusion or not,the temperature of the central region in the left liver were 44.02±0.06?and 43.04±0.07?(p<0.05),the temperature of the marginal zone were 43.54±0.08?and 42.64±0.07?(p<0.05),respectively.The liver function in group 50? was normal,but group 55?and group 60?showed a transient damage,and all of them recovered to normal on d7 after the operation.There was no significant difference between the two groups.In group 65?,liver function was significantly impaired,and there was significant difference before and after operation(P< 0.05).Pathology examination showed liver cells without abnormal,mild swelling,obvious swelling with necrosis and inflammatory cell infiltration In group 50?,in group 55-60 ?,and group 65 ? respectively.3.After procedure,the study group and the control group were followed up for 2 months,and the survival of the experimental group was from 22 days to 55 days,(mean 44.1±8.2days)and control group from 18 days to 41 days(mean 36.2±6.3days)(p<0.05).All animals were demonstrated various degrees of liver damage after operation,but no statistical difference was found between pre-operation and post-operation.However,the serum AST level in the experimental group was significantly higher than that in the control group at d3 after procedure(P < 0.05).The tumor growth rate in the experimental group was 0.93±0.21,tumor volume from 1732±335 to 1611±238 mm3),which was significantly lower than that in the control group(1.12±0.26,tumor volume from 1729±401 to1931±224±224 mm3)(P < 0.05).Conclusion1.The method of establishing rabbit VX2 liver tumor model by enhanced CT-guided percutaneous tumor lumps implantation showed lots of advantages,such as short operation time,simple manipulation and less complications,and it could avoid injurying blood vessels and bile ducts of the liver.2.Dynamic contrast-enhanced spiral CT was of great value to evaluate the lesions,and the imaging findings were consistent with the DSA angiography and postoperative pathological findings.2-3 weeks after tumor was the best time for interventional therapy.3.TATC-IVCBO could reduce the loss of heat obviously,and it showed that 60 ? was the best pouring temperature.TATCE-IVCBO with treatment of hepatic vx2 tumor in rabbitswas effective and safe4.By the experiment of TATCE-IVCBO of hepatic vx2 tumor in rabbits,we may certify that the therapy is effect and safety. |
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