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目的探讨热碘油联合90钇(90Y)瘤内注射治疗肝癌的安全性和可行性。方法将40只荷瘤昆明小鼠随机分为A、B、C、D组各10只。A组瘤内注射0.1m l热碘油与0.1m l(100μC i)90Y混悬液;B组注射0.1m l热碘油;C组注射0.1m l(100μC i)90Y;D组注射0.1m l生理盐水。A、C组注药后2h、3d、7d、10d、14d在γ相机和ECT扫描仪下观察放射性分布情况。各组在上述时间点抽血查肝、肾功能及血常规,并测肿瘤最大径a和最小径b,计算肿瘤体积及肿瘤生长率,同时取肿瘤组织作病理检查。结果除肿瘤外,A、C组小鼠其他脏器内均未发现90Y沉积,病理切片也未显示小鼠其他脏器因90Y放射损伤所致的病理改变。A、B、C、D组小鼠肝、肾功能及血常规均无变化,未见有心、肺、脾、肾的病理改变及骨髓抑制等。注药后第3天起,D组肿瘤生长迅速,生长率在3、7、10、14d时分别为13%、20%、29%、36%,与A组(分别为-11%-、19%-、29%-、38%)、B组(分别为-6%、-9%-、11%-、16%)、C组(分别为-1%-、3%-、6%-、9%)比较,差异均有显著性,P均<0.01;各时间点A组生长率最低,与其他各组相比,差异有显著性,P均<0.05;B组也低于C组,差异有显著性,P均<0.05。D组在3~14d肿瘤坏死范围均未超过30%;A组肿瘤重度坏死率在3、7、10及14d时分别为58%、68%、77%及87%,与B、C、D组比较,差异有显著性,P均<0.01;B、C、D组坏死率呈降低趋势,且组间差异有显著性,P均<0.05。结论热碘油联合90Y瘤内注射治疗小鼠肝癌安全、有效。
Objective To investigate the safety and feasibility of thermal lipiodol combined with 90 Y (90Y) intratumoral injection in the treatment of liver cancer. Methods Forty mice bearing Kunming mice were randomly divided into A, B, C and D groups. In group A, 0.1m l of thermal lipiodol and 0.1m l (100μC i) 90Y were injected intratumorally. Group B received 0.1m l of thermal lipiodol. Group C received 0.1mℓ (100μC i) of 90Y; group D received 0.1mℓ of normal saline. A, C group 2h, 3d, 7d, 10d, 14d after injection, observe the radioactive distribution under the γ camera and ECT scanner. At the above time points, blood samples were taken from each group to check the liver, renal function and blood routine. The maximal diameter a and minimum diameter b were calculated. The tumor volume and tumor growth rate were calculated. At the same time, the tumor tissues were taken for pathological examination. Results In addition to the tumor, 90Y deposits were not observed in other organs of mice in groups A and C, and pathological changes of 90Y mice were not observed in other organs of mice. There was no change in liver and kidney function and blood routine in groups A, B, C and D, no pathological changes of lung, spleen and kidney, bone marrow suppression and so on were found. From the third day after injection, the tumors in group D grew rapidly with the growth rates of 13%, 20%, 29% and 36% at 3, 7, 10 and 14 days respectively, which were significantly lower than those in group A (-11% 19% -, 29% - and 38% respectively), group B (-6%, -9%, 11% and 16% -, 9%), the difference was significant (P <0.01). The growth rate of group A was the lowest at all time points, and the difference was significant compared with other groups Group, the difference was significant, P <0.05. In group D, the tumor necrosis ranged from 30% to 14 days. The rates of severe necrosis in group A were 58%, 68%, 77% and 87% at 3, 7, 10 and 14 days, respectively, The difference was significant (P <0.01). The necrosis rates of group B, C and D showed a decreasing tendency, and there was significant difference between groups (P <0.05). Conclusion Thermal lipiodol combined with 90Y intratumoral injection in the treatment of mouse liver cancer is safe and effective.