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目的研究经肝动脉碘油抗癌药乳液化疗栓塞(LP-THACE)后早期的肝肿瘤细胞凋亡。方法27只新西兰大白兔肝VX2肿瘤模型,分成LP-THACE组、THAI(肝动脉灌注化疗)组和对照组(肝动脉灌注生理盐水),在处理后24h、72h、120h处死取材。HE染色光镜检查观察具有典型形态学特征凋亡细胞,分析凋亡指数(AI);FITC-AnnexinV/PI双染法流式细胞术(FCM)检测凋亡早期细胞与凋亡晚期细胞,分析凋亡细胞百分率。结果LP-THACE组凋亡指数(%)在三个不同时间点,瘤外周带依次为5.05±1.02、4.52±0.51、2.81±0.28,瘤中心依次为18.08±0.31、20.25±0.61、14.97±1.33,明显大于THAI组与对照组(P<0.05)。LP-THACE组瘤外周带的凋亡早期细胞百分率在三个不同时间点依次为11.44±4.78、10.99±5.77、5.99±0.57,凋亡晚期细胞百分率为33.21±11.33、38.40±7.77、28.76±7.21;LP-THACE组瘤中心带的凋亡早期细胞百分率在三个不同时间点依次为23.74±3.38、14.43±3.25、11.28±3.42,凋亡晚期细胞百分率为28.50±2.12、52.94±18.97、49.22±22.04。结论LP-THACE诱导兔肝VX2肿瘤在介入处理后的早期发生了明显的肿瘤细胞凋亡,介入治疗诱导肿瘤细胞凋亡的作用集中在早期;诱导凋亡性死亡是LP-THACE治疗肝癌的主要机制。肿瘤中心区域比肿瘤周边区域凋亡对凋亡诱导因子敏感。
Objective To study the early apoptosis of hepatic tumor cells after hepatic artery lipiodol anticancer emulsion chemoembolization (LP-THACE). Methods Twenty-seven New Zealand white rabbits with liver VX2 tumor model were divided into LP-THACE group, THAI group and control group (hepatic artery perfusion with saline), and were sacrificed 24h, 72h, 120h after treatment. The apoptotic index (AI) was analyzed by HE staining and apoptotic index (AI) was observed by flow cytometry (FITC-AnnexinV / PI double staining) Apoptotic cells percentage. Results The apoptotic index (%) in LP-THACE group was 5.05 ± 1.02, 4.52 ± 0.51 and 2.81 ± 0.28 at three different time points, and the tumor centers were 18.08 ± 0.31, 20.25 ± 0.61 and 14.97 ± 1.33 , Significantly higher than THAI group and control group (P <0.05). The percentage of early apoptotic cells in LP-THACE group was 11.44 ± 4.78,10.99 ± 5.77,5.99 ± 0.57 at three different time points, and the percentage of apoptotic cells was 33.21 ± 11.33,38.40 ± 7.77,28.76 ± 7.21 ; The percentage of early apoptotic cells in LP-THACE group was 23.74 ± 3.38,14.43 ± 3.25,11.28 ± 3.42 at three different time points, the percentage of apoptotic cells was 28.50 ± 2.12,52.94 ± 18.97,49.22 ± 22.04. Conclusion LP-THACE-induced VX2 tumor in rabbit liver tissue had obvious tumor cell apoptosis in the early stage after interventional therapy, and the effect of interventional therapy on inducing tumor cell apoptosis was concentrated in the early stage. Inducing apoptotic death was the main treatment for hepatocellular carcinoma by LP-THACE mechanism. Apoptosis is more sensitive to apoptosis-inducing factor in tumor center than in tumor surrounding area.