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目的探讨用交变电磁场(E)介导纳米氧化铁粒磁性顺铂微球(nCDDPmm)靶向栓塞热化疗治疗肝癌的作用。方法制备移植性兔 VX_2肝癌模型,随机分5组经肝动脉插管灌注:(1)对照组,生理盐水+40 kHz、24kA/min 的 E30min;(2)nCDDPmm(铁30mg/kg,顺铂2mg/kg)+E 组;(3)纳米铁粒磁性微球(nmm,铁30mg/kg)+E 组;(4)nCDDPmm 组:(5)nmm 组。用光纤温度测量仪监测癌中心区、癌边缘区、正常肝组织和直肠的温度变化;观察治疗时和治疗后14d 肝癌体积的变化,肿瘤生长率,肝癌和肝组织的病理变化。结果 nCDDPmm+E 和 nmm+E 组的癌中心区(43.71℃,43.66℃)和癌边缘(40.21℃,40.63℃)的温度显著高于正常肝组织(36.95℃.36.21℃)和直肠(36.18℃,35.88℃)(P<0.01),对照组、nCDDPmm 和 nmm 未加 E 组各部位的温度无明显升高。14d 后,除 nCDDPmm+E 组肿瘤体积缩小外,其余各组的肿瘤体积增大4～15倍;各组肿瘤生长率分别为600%,—63%,139%,428%,598%(P<0.01)。nCDDPmm+E 组肝癌细胞大面积坏死(70%以上)。癌灶及癌边缘可见到栓塞的微球,其余各组的肝癌细胞中到轻度坏死(0～70%),正常肝组织未见明显的微球和坏死。结论交变电磁场可以通过诱导兔 VX_2肝癌靶区栓塞 nCDDPmm 和 nmm 的温度升高,介导靶区温度升高达43℃以上,磁介导的热疗对顺铂化疗有明显的协同作用。
Objective To investigate the effect of nCDDPmm targeted electro-chemoembolization (PTC) in the treatment of hepatocellular carcinoma with alternating electromagnetic field (E). Methods The transplanted rabbit model of VX 2 hepatocellular carcinoma was prepared and randomly divided into 5 groups: (1) control group, physiological saline +40 kHz, E30min at 24kA / min; (2) nCDDPmm 2mg / kg) + E group; (3) Nano iron particles magnetic microspheres (nmm, iron 30mg / kg) + E group; (4) nCDDPmm group: (5) nmm group. The changes of the temperature of the cancer center, the marginal zone, the normal liver tissue and the rectum were monitored by the optical fiber temperature meter. The changes of the volume of the liver cancer, the tumor growth rate, the pathological changes of the liver cancer and the liver tissue were observed 14 days after treatment and after treatment. Results The nCDDPmm + E and nmm + E groups had significantly higher temperature (43.71 ℃, 43.66 ℃) and cancer margin (40.21 ℃, 40.63 ℃) than normal liver tissues (36.95 ℃, 36.21 ℃) and rectum , 35.88 ℃) (P <0.01). There was no significant increase in the temperature of the control group, nCDDPmm and nmm without E group. After 14 days, the volume of tumor in each group increased 4 ~ 15 times, except for the nCDDPmm + E group, the tumor growth rate was 600%, -63%, 139%, 428%, 598% <0.01). NCDDPmm + E large area of liver cancer cell necrosis (70%). Embolization of the microspheres can be seen on the foci and margins of cancer, mild necrosis (0 ~ 70%) in the remaining groups of liver cancer cells, no obvious microspheres and necrosis in normal liver tissue. CONCLUSION: The alternating electromagnetic field can induce the temperature increase of nCDDPmm and nmm in target area of rabbit VX-2 hepatocarcinoma, and the temperature of the target area can be increased by more than 43 ℃. Magnetic-mediated hyperthermia has obvious synergistic effect on cisplatin chemotherapy.