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目的 探讨肝交感或迷走神经分别或两者联合膈神经切断术对Wistar大鼠肝癌生长及侵袭转移的影响。方法 应用Wistar大鼠肝癌模型 ,在外科显微镜下选择性切断支配靶肝叶的肝交感或肝迷走神经及膈神经分支 ,在肝自主神经联合切断术 (HANCA)同时切除肿瘤并分别采用肝动脉化疗栓塞 (HAE)、门静脉化疗栓塞 (PVE)及肝管化疗栓塞 (HBDE)法。观察肝肿瘤大体形态、肿瘤生长率、肿瘤坏死面积、动物生存期及肿瘤复发转移、肝癌细胞凋亡及S 10 0阳性蛋白表达。结果 支配靶肝叶的肝自主神经联合切断术及同时切除肝肿瘤并分别与HAE、PVE及HBDE的作用效果显著高于单一的肝交感或迷走神经切断术的效果。结论 肝自主神经联合切断术 +肿瘤切除或分别与HAE、PVE及HBDE是有效控制肝癌生长及侵袭转移的较理想手段。
Objective To investigate the effect of hepatic sympathetic or vagus nerve or both combined with phrenic nerve amputation on the growth, invasion and metastasis of hepatoma in Wistar rats. Methods The Wistar rat liver cancer model was used to selectively sever the hepatic sympathetic or hepatic vagus nerve and phrenic nerve branches that govern the target hepatic lobe under a surgical microscope. At the same time, the hepatic artery aneurysmectomy (HANCA) was used to remove the tumor and hepatic artery chemoembolization was performed. (HAE), portal vein chemoembolization (PVE) and hepatic chemoembolization (HBDE). The gross morphology, tumor growth rate, tumor necrosis area, animal survival, tumor recurrence and metastasis, hepatoma cell apoptosis and S 10 0 positive protein expression were observed. Results The effect of combined hepatic autonomic nerve severing on the target liver lobe and simultaneous resection of hepatic tumors with HAE, PVE, and HBDE was significantly higher than that of a single hepatic sympathetic or vagotomy. Conclusion Liver autonomic nerve transection combined with tumor resection or HAE, PVE and HBDE are effective methods to control the growth, invasion and metastasis of HCC.