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目的:探讨MR扩散加权成像(DWI)结合实验室检查观察四君子汤对移植性原发性肝癌小鼠肿瘤生长的影响。方法:30只移植性原发性肝癌小鼠随机分为模型组、5-FU组及四君子汤组,每组10只。模型组和四君子汤组小鼠分别给予蒸馏水和四君子汤灌胃,每天1次,连续给药10天;5-FU组隔天给予5-FU腹腔注射。第15天进行MR检查,测量肿瘤组织的表观扩散系数(ADC),利用三维最大强度投影(3D-MIP)重组及黑白反转技术,观测病变显示效果。观察各组小鼠的瘤重、脾重、血清血管内皮生长因子(VEGF)及肿瘤细胞凋亡。结果:在扩散敏感因子(b)=600s/mm2的DWI图像中,肿瘤多表现为高信号,其内的坏死部分为低信号,肿瘤实质部分的ADC值为:1421±160s/mm2;肿瘤ADC值及血清VEGF比较,四君子组低于模型组(P<0.01),高于5-FU组(P<0.01)。小鼠肿瘤ADC值与血清VEGF水平呈正相关,与细胞凋亡呈负相关。细胞凋亡,四君子汤组显著高于模型组(P<0.01)。小鼠瘤重和肿瘤指数,四君子汤组显著低于模型组(P<0.01)。5-FU组抑瘤率(54.67%)>四君子汤组(17.81%)。脾脏重量及脾脏指数比较,四君子汤组显著高于模型组和5-FU组(P<0.01)。结论:四君子汤对小鼠移植性原发性肝癌的作用机制在于促进肿瘤细胞的凋亡,抑制血清VEGF的表达;ADC值可以反映四君子汤对肿瘤生长抑制的情况;MR扩散加权成像及ADC值在评价四君子汤治疗小鼠移植性原发性肝癌疗效方面具有可行性,是评定中药疗效的新型手段。
Objective: To investigate the effect of Sijunzi Decoction on tumor growth in mice with transplanted hepatocellular carcinoma (HCC) by MR diffusion weighted imaging (DWI) combined with laboratory tests. Methods: Thirty mice with primary hepatocellular carcinoma were randomly divided into model group, 5-FU group and Sijunzitang group, with 10 mice in each group. Mice in the model group and the Sijunzi Decoction group were administered with distilled water and Sijunzi decoction orally, once daily for 10 days. 5-FU intraperitoneal injection was given to the 5-FU group. On the 15th day, MR examination was performed to measure the apparent diffusion coefficient (ADC) of the tumor tissue. The 3D-MIP recombination and black-and-white inversion technique were used to observe the lesion display effect. The tumor weight, spleen weight, serum vascular endothelial growth factor (VEGF) and tumor cell apoptosis in each group were observed. Results: In the DWI images with diffusion sensitive factor (b) = 600s / mm2, the tumor mostly showed high signal and the necrotic part was low signal. The ADC value of the tumor part was 1421 ± 160s / mm2. The tumor ADC Compared with the serum VEGF, the Sijunzi group was lower than the model group (P <0.01) and higher than the 5-FU group (P <0.01). ADC value of mouse tumor was positively correlated with serum VEGF level and negatively correlated with apoptosis. Apoptosis, Sijunzi soup group was significantly higher than the model group (P <0.01). The tumor weight and tumor index of mice in Sijunzi Decoction group were significantly lower than those in model group (P <0.01). The inhibition rate of 5-FU group (54.67%)> Sijunzi decoction group (17.81%). Spleen weight and spleen index, Sijunzi Decoction group was significantly higher than the model group and 5-FU group (P <0.01). Conclusion: The mechanism of Sijunzi Decoction on mice with transplanted primary liver cancer is to promote the apoptosis of tumor cells and inhibit the expression of serum VEGF. The ADC value can reflect the inhibition of Sijunzi decoction on tumor growth. MR diffusion weighted imaging and ADC value It is feasible to evaluate the curative effect of Sijunzi Decoction on transplanted primary liver cancer in mice and it is a new measure to evaluate the curative effect of traditional Chinese medicine.