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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 ,设计了选择性胆管支、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 ,并观察了瘤周纤维增生特点。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。对比观察大鼠病死率、转移率、治疗成功率 ;原位杂交检测α1( I)、α1( IV)型前胶原 m RNA表达及定位情况。结果 :手术组瘤周纤维包裹紧密与对照组相比病死率 31 .3%∶ 68.8%、腹腔转移率 31 .3%∶ 62 .5 %、肝内转移率 1 2 .5 %∶ 43.8%、腹腔转移合并肝内转移率 6.3%∶ 37.5 %、肺转移率 0∶ 1 8.8%、治疗成功率为 43.8% ;癌周纤维化早期 ,Ito细胞及 MF主要对α1( IV)前胶原 m RNA做出表达 ,中期α1( I)前胶原 m RNA杂交信号开始出现并增多 ,后期二者趋于稳定。结论 :联合结扎法可使肝癌团块周围发生广泛的肝纤维化 ,有效的包裹和限制了肝癌细胞团的膨胀性生长 ,显著地降低了肝癌病死率、腹腔和肝内转移率及肺转移率 ;Ito细胞是癌周纤维化过程中胶原生成的先驱细胞 ,激活后的 Ito细胞可进一步转变为 MF和 Fb,成为癌周纤维化过程中的主要胶原生成细胞 ,纤维条束及其中的胶原生成细胞对癌细胞的生
OBJECTIVE: To design a method of selective biliary branches and portal vein ligation in order to solve the problems of low resection rate, large surgical trauma and high metastatic rate of advanced liver cancer, and to study the therapeutic effect of transplanted liver cancer in rats Peritumor fibrosis characteristics. Methods: The model of Wister rat hepatocellular carcinoma was established by using R-35 rat hepatoma tumor cell line, and the portal vein biliary branch ligation and control operation with lobectomy were performed in groups. The mortality, metastasis rate and success rate of treatment were observed and compared. The expression and localization of α1 (I) and α1 (IV) procollagen mRNA were detected by in situ hybridization. Results: The peritumoral fibrosis rate in the operation group was 31.3%, 68.8%, 31.3%, 62.5% respectively, the intrahepatic metastasis rate was 12.5%, 43.8% Intraperitoneal metastasis combined with intrahepatic metastasis rate of 6.3%: 37.5%, lung metastasis rate of 0: 1 8.8%, treatment success rate was 43.8%; early peritoneal fibrosis, Ito cells and MF mainly α1 (IV) procollagen m RNA do The expression of α1 (I) procollagen m RNA began to appear and increased in the mid-stage, while the latter two tended to be stable. Conclusion: The combined ligation method can cause extensive hepatic fibrosis around the liver cancer mass, and effectively encapsulate and limit the swollen growth of liver cancer cell mass, significantly reducing the mortality of liver cancer, intra-abdominal and intrahepatic metastasis and lung metastasis ; Ito cells are the precursors of collagen production during peri-cancerous fibrosis. Ito cells after activation can be further transformed into MF and Fb, becoming the major collagen-producing cells in the peritumoral fibrosis process. Fiber bundles and collagen production in them Cells of cancer cells