Experimental and clinical studies on indication and safety of portal embolization

目的目前对多发性肝癌的治疗效果并不令人满意。本研究旨在探讨经导管门静脉栓塞（TPE）对大鼠实验性肝转移的影响。所有大鼠（n=24）分为4组，第2次手术后10天处死。1)A组;对照组（2）B组;门静脉左分支TPE（占肝脏总量的70%）3）C组：门静脉左支结扎4）D组：肝左动脉结扎。观察各组肿瘤大小、组织血流量、右叶再生率、NK细胞活性及PCNA、凋亡、VEGF免疫组化染色。右叶明显肥大 关于我们 B、C组大鼠体重明显增加，A、D组大鼠体重明显下降。A、B、C、D组左/右肺肿瘤数分别为92.6 <plus-minus>23.5/32.3 <plus-minus>9.6、88.2 <plus-minus>36.2/5.4 <plus-minus>2.3、121.3 <plus-minus>28.6/6.9 <plus-minus>2.1、32.3 <plus-minus>5.6/66.0 <plus-minus>20.5。C组左叶肝血流量由31.9 ± <plus-minus>6.5 ml/min/100 g增至9.0 ± 3.2 ml/min/100 <plus-minus>g，<plus-minus>门静脉左支增至18.2 ± 4.2 ml/min/100 g，提示C组左叶肝动脉血流量代偿性增加。肿瘤组织中无VEGF表达和细胞凋亡。TPE的这一有吸引力的概念可能在多发性肝癌的临床环境中具有实用性。少

ObjectivesCurrent available treatments for multiple liver cancer are not satisfactory. The aim of this study is to investigate the effects of transcatheter portal embolization (TPE) on the development of experimental liver metastasis in rats.Methods1*10^6 of tumor cells (AH130 hepatoma cell origined from rat) were injected intraportally into Donryu rats to produce liver metastasis 10 days later. All rats (n=24) were divided into four groups and killed 10 days after second operation. 1) Group A ; Control 2) Group B ; TPE of the left branch of portal vein (70% of the total liver) 3) Group C ; left portal ligation 4) Group D ; left hepatic artery ligation. Tumor size, tissue blood flow, regeneration rate of the right lobe, NK activity and immunohistochemical staining of PCNA,apoptosis, VEGF were studied in each group.ResultsPrimarily, hepatic arterial and portal angiography revealed that the tumor had well-developed arterial circulation. Significant hypertrophy of the right lobe and atrop … More hy of the left lobe were observed in Group B and Group C.Rats'weight increased significantly in group B and C,while decreased in Group A and D.Tumor numbers (left/right lobe) were 92.6<plus-minus>23.5/32.3<plus-minus>9.6,88.2<plus-minus>36.2/5.4<plus-minus>2.3,121.3<plus-minus>28.6/6.9<plus-minus>2.1,32.3<plus-minus>5.6/66.0<plus-minus>20.5 in Group A,B,C and D,respectively. Liver blood flow of the left lobe changed from 31.9<plus-minus>6.5 ml/min/100g to 9.0<plus-minus>3.2 in clamp of the main portal vein and to 18.2<plus-minus>4.2 in clamp of the left portal vein branch, suggesting compensatory increase of hepatic artery flow in the left lobe in Group Band C.Expression of VEGF and apoptosis in the tumors did noConclusionTPE resulted in marked hepatic hypertrophy and significant reduction of tumor growth in the non-embolized lobe, probably owing to decrease in arterial flow in the non-embolized lobe. This attractive concept of TPE may have utility in the clinical setting in the event of multiple liver cancer. Less