A preliminary study of ALPPS procedure in a rat model.
A preliminary study of ALPPS procedure in a rat model.
复制标题
大鼠模型ALPPS程序的初步研究
DOI：
10.1038/srep17567
复制
发表时间：
2015-12-03
影响因子：
4.6
通讯作者：
Liu L
中科院分区：
文献类型：
--
作者：
Shi H;Yang G;Zheng T;Wang J;Li L;Liang Y;Xie C;Yin D;Sun B;Sun J;Wang H;Pan S;Jiang H;Lau W;Liu L
联合肝分割门静脉结扎分期肝切除术(ALPPS)已被报道为一种新的外科技术，可提供快速有效的残肝生长。尽管偶尔会有动物研究的报道，但ALPPS快速肝再生的机制仍不清楚。在本研究中，我们打算建立一种可复制的模拟ALPPS的大鼠模型，并探讨其潜在的机制。门静脉结扎组(PVL)、左外叶切除组(LLL)、肝横断组和假手术组大鼠作为对照组。结果表明，ALPPS后残肝的再生率是PVL的2倍，而单纯横断组的体积增加很小。ALPPS后Ki-67和增殖细胞核抗原的表达水平较横断组和切除组高约10倍，比PVL组高4倍。ALPPS组大鼠残肝组织中肿瘤坏死因子-α、IL-6和肝细胞生长因子的水平约为对照组的3倍。ALPPS后NF-κB P65、STAT3和YAP的激活更为明显，提示PVL和横断术协同激活这些通路，可能在ALPPS后肝再生中起重要作用。
Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has been reported to be a novel surgical technique that provides fast and effective growth of liver remnant. Despite occasional reports on animal studies, the mechanisms of rapid liver regeneration in ALPPS remains unclear. In the present study, we intend to develop a reproducible rat model to mimick ALPPS and to explore the underlying mechanisms. Rats assigned to the portal vein ligation (PVL), left lateral lobe (LLL) resection, transection and sham groups served as controls. Results indicated that the regeneration rate in the remnant liver after ALPPS was two times relative to PVL, whereas rats with transection alone showed minimal volume increase. The expression levels of Ki-67 and PCNA were about ten-fold higher after ALPPS compared with the transection and LLL resection groups and four-fold higher compared with the PVL group. The levels of TNF-α, IL-6 and HGF in the regenerating liver remnant were about three-fold higher after ALPPS than the controls. There was a more significant activation of NF-κB p65, STAT3 and Yap after ALPPS, suggesting synergistic activation of the pathways by PVL and transection, which might play an important role in liver regeneration after ALPPS.