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肝細胞癌の治療のためのインターベンショナル光熱療法と併用した経皮的動脈内輸液
Transcatheter Intra-Arterial Infusion Combined with Interventional Photothermal Therapy for the Treatment of Hepatocellular Carcinoma.
PMID: 32184592 PMCID: PMC7053813. DOI: 10.2147/IJN.S233989.
抄録
背景:
光熱療法（PTT）は、腫瘍の治療に大きな可能性を秘めている。しかし、近赤外光（NIR）の透過性が低く、腫瘍部位のナノ材料の濃度が低いため、PTTの応用は限られている。
Background: Photothermal therapy (PTT) has great potential application in the treatment of tumors. However, due to the low penetration of near-infrared light (NIR) and the low concentration of nanomaterials in the tumor site, the application of PTT has been limited.
目的:
本研究の目的は、レシチン修飾Biナノ粒子（Bi-Ln NP）とインターベンショナルPTT（IPTT）を併用した肝細胞癌に対する肝動脈内輸液の治療効果を検討することであった。
Purpose: The objective of this study was to investigate the therapeutic effect of transcatheter intra-arterial infusion of lecithin-modified Bi nanoparticles (Bi-Ln NPs) combined with interventional PTT (IPTT) on hepatocellular carcinoma.
方法:
Methods: Bi-Ln NPs were prepared by emulsifying the hydrophobic Bi nanoparticles and lecithin, and the photothermal conversion and cytotoxicity of Bi-Ln NPs were then measured by infrared imaging and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, respectively. Twenty-four VX2 hepatic carcinoma rabbits were randomly divided into four groups. Rabbits in group A received Bi-Ln NPs by intra-arterial infusion and NIR laser treatment (IA Bi-Ln NPs + Laser), group B received Bi-Ln NPs by intravenous infusion and NIR laser treatment (IV Bi-Ln NPs + Laser), group C received PBS (phosphate buffer saline) via intra-arterial infusion with NIR laser treatment (IA PBS + Laser), group D received PBS via intra-arterial infusion (IA PBS). Transcatheter intra-arterial infusion was conducted by superselective intubation under digital subtraction angiography (DSA) guidance. IPTT was performed by introducing an NIR optical fiber access to the rabbit VX2 hepatic carcinoma under real-time ultrasound guidance. Magnetic resonance imaging (MRI) was performed to evaluate the tumor size. Hematoxylin and eosin (H&E) stain and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) were conducted 7 days after treatment to evaluate the necrosis rate and viability of tumor, respectively.
結果:
Bi-Ln NPは、良好な生物学的適合性と高い光熱変換効率という利点を有する。また、低侵襲的な経カテーテルを用いた動脈内注入により、腫瘍組織中のBi-Ln NPの濃度を著しく増加させることができる。IPTTは、Bi-Ln NPの光熱変換効率の著しい改善に寄与することができる。IA Bi-Ln NPs + Laserのグループは、他のグループと比較して、治療後の腫瘍抑制率（TIR）が93.38±19.57％、腫瘍壊死率が83.12±8.02％、アポトーシス率が（43.26±10.65％）と有意に高かった。
Results: The Bi-Ln NPs have the advantages of good biological compatibility and high photothermal conversion efficiency. Minimally invasive transcatheter intra-arterial infusion can markedly increase the concentration of Bi-Ln NPs in tumor tissues. IPTT can contribute to the significant improvement in the photothermal efficiency of Bi-Ln NPs. Compared to other groups, the group of IA Bi-Ln NPs + Laser showed a significantly higher tumor inhibition rate (TIR) of 93.38 ± 19.57%, a higher tumor necrosis rate of 83.12 ± 8.02%, and a higher apoptosis rate of (43.26 ± 10.65%) after treatment.
結論:
介入型PTT（IPTT）と組み合わせた経カテーテル内輸液は、腫瘍細胞の根絶と腫瘍増殖の抑制に安全かつ効果的であり、将来的には肝細胞癌の治療に新たな価値ある選択肢を提供する可能性があります。
Conclusion: Transcatheter intra-arterial infusion combined with interventional PTT (IPTT) is safe and effective in eradicating tumor cells and inhibiting tumor growth and may provide a novel and valuable choice for the treatment of hepatocellular carcinoma in the future.
© 2020 Zhou et al.