权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Experimental study on surgery of portal tumor thrombus of hepatocellular carcinoma. tumor cell-endothellal cell adhesion and uptake of thrombolytic agents in thrombus.

肝细胞癌门静脉癌栓手术的实验研究。

基本信息

批准号：
61570607
负责人：
KUMADA Kaoru
金额：
$ 1.47万
依托单位：
Kyoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1986
资助国家：
日本
起止时间：
1986 至 1987
项目状态：
已结题

项目摘要

Hepatocellular carcinoma with tumor thrombus in the portal vein trunk is of imminently poor prognosis and has been considered out of surgical indication. Recently we have advocated removal of such tumor thrombi with successful evidences. However, there are two problems involved in practice: intrahepatic tumor celldissemination and portal vein thrombosis after the operation. We performed in vitro assay tumor cell-adhesion to the endothelial cell of hepatic sinusoid assay and experimental evaluation of intraportal administration of fibrinolytic agents.Heparin depressed the number of tumor cell adhesion to endothelial cells by 45%, while anticancer agents such as Adriamycin, MMC and 5FU increased the number by 150-400%. The perportal fibrinolytic therapy with urokinase of tissue plasminogen activator was effetive so much as in the pelvic vein. Mild liver dysfunction was induced by intrapotal urodinase injection.These results suggest that anti thrombotic agent is preferable for the prevention of tumor cell dissemination and anticancer agen t has reverse effect probably by endothelial injury and that fibrinolytic therapy is useful for the postoperative portal thrombosis. but further investigation should be done about the hepatic side effect etc.

原发性肝癌合并门静脉主干癌栓预后极差，已被排除手术指征。近年来，我们提倡切除这种肿瘤血栓，并取得了成功的证据。然而，在实际操作中存在两个问题：肿瘤细胞的肝内播散和术后门静脉血栓形成。我们进行了肿瘤细胞与肝窦内皮细胞粘附的体外实验、肝窦内皮细胞粘附实验和纤溶药物门静脉给药的实验研究，发现肝素可使肿瘤细胞与内皮细胞粘附的数量减少45%，而抗癌药物如阿霉素、丝裂霉素和5-氟尿嘧啶可使粘附的数量增加150- 400%。尿激酶或组织型纤溶酶原激活剂经门静脉溶栓治疗效果与盆腔静脉溶栓治疗相同。结果提示，抗栓药物对防止肿瘤细胞播散有较好的效果，抗癌阿根可能通过损伤内皮细胞而发挥逆转作用，纤溶治疗对术后门静脉血栓形成有一定的疗效。但对肝脏的副作用等还需进一步研究。