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目的 为解决中晚期肝癌临床切除率低、手术创伤大、转移率高等问题 ,我们设计了含瘤肝叶胆管支、门静脉支联合结扎的方法 ,对大鼠移植性肝癌模型进行了治疗性研究。方法 应用R 35大鼠肝癌瘤株制备Wister大鼠移植性肝癌模型 ,分组实施含瘤肝叶的门静脉支胆管支联合结扎术及对照手术。对比观察大鼠死亡率、转移率、治疗成功率 ;原位末端检测观察癌细胞凋亡情况 ;免疫组化测定肝癌细胞MMP 9表达情况 ;免疫组化方法观察Ito细胞、Ⅰ、Ⅳ型胶原的增生情况 ;原位杂交检测α1Ⅰ、α1Ⅳ型前胶原mRNA表达及定位情况。结果 手术组与对照组相比死亡率 31 3%∶6 8 8%、腹腔转移率 31 3%∶6 2 5 %、肝内转移率 12 5 %∶4 3 8%、腹腔转移合并肝内转移率 6 3%∶37 5 %、治疗成功率为 4 3 8% ;对照组平均AI值 =4 32± 0 2 4 ,治疗组平均AI值 =12 80± 1 17;纤维包裹癌团MMP 9表达总阳性率为 2 4 2 4 %、强阳性率为 9 0 9% ,自由生长癌团MMP 9表达总阳性率为 87 88%、强阳性率为 4 2 4 2 % ;Ito细胞和Ⅳ型胶原完成早期瘤周纤维包裹 ,为I型胶原的沉积做出引导和铺垫 ;癌周纤维化早期 ,Ito细胞及MF主要对α1(Ⅳ )前胶原mRNA做出表达 ,中期α1(Ⅰ )前胶原mRNA杂交信号开始出现并增多 ,后期二者趋于稳定。结论 联?
Objective To solve the problem of low resection rate, large surgical trauma and high metastatic rate of advanced liver cancer, we designed a method for the treatment of transplanted liver cancer in rats with the method of combining the ligation of biliary branches and portal branches of the liver. Methods The rat model of Wister rat hepatocellular carcinoma (HCC) was established by using the R 35 rat hepatoma tumor model. The portal vein biliary branches and ligation combined with ligation and operation were performed in groups. The death rate, metastasis rate and success rate of treatment were compared. The apoptosis of cancer cells was observed by end-of-life test. The expression of MMP-9 in hepatocellular carcinoma cells was detected by immunohistochemistry. Hyperplasia; situ hybridization detection α1 Ⅰ, α1 Ⅳ procollagen mRNA expression and location. Results Compared with the control group, the mortality of the operation group and the control group was 31.3% and 68.8% respectively. The rate of peritoneal metastasis was 31.3% and 52.5% respectively. The intrahepatic metastasis rate was 125.3% and 43.8% respectively. The intra-abdominal metastasis combined with intrahepatic metastasis The mean AI value of the control group was 42 32 ± 0 2 4, and the average AI value of the treatment group was 12 80 ± 1 17. The MMP 9 expression in the fibrous-coated cancer group The total positive rate was 224.4%, the strong positive rate was 9 0 9%. The positive rate of MMP 9 expression in free-growth cancers was 87 88% and the strong positive rate was 4224%. Ito cells and type IV collagen The peritumoral fibrosis was completed in early peritumoral weeks, which was the guide and bedding for the deposition of type I collagen. In the early stage of peritumoral fibrosis, Ito cells and MF mainly expressed α1 (Ⅳ) procollagen mRNA. Hybridization signal began to appear and increased, the latter two tend to be stable. Conclusions