615小鼠肝部分切除术后高凝状态对肿瘤转移的影响

Influence of partial hepatectomy-induced hypercoagulable activity on experimental liver metastasis

  • 摘要: 目的 探讨肝癌手术切除后机体凝血活性的改变对肿瘤复发和转移的影响。方法 切除正常成年615小鼠部分肝脏,24h后取血测凝血活性;在部分肝切除(PH)同时脾接种瘤细胞,在术前后分别给予纤溶酶抗凝治疗,饲养动物11d后分析肿瘤转移程度。结果 单纯PH组术后血小板聚集(PLT)和纤维蛋白原(Fbg)含量显著增加(P=0.018,P=0.012),提示凝血活性显著增高;由于凝血因子消耗,部分凝血活酶时间(APTT)和凝血酶原(PT)显示有延长(P=0.007,P=0.002)。在给予PH组动物纤溶酶处理后,除PT外几乎全部恢复术前水平(P>0.05)。手术+抗凝治疗组肿瘤转移程度较单纯手术组有明显减弱(P=0.003)。结论 PH后机体高凝状态与术后肿瘤转移增强有明显相关。

     

    Abstract: Objective To investigate the influence of partial hepatectomy(PH)-induced hypercoagulable activity on experimental liver metastasis. Methods PH was performed on 615 adult normal mice and their coagulating activities were measured 24 hours after operation. The mice were injected intravenously with intrasplenic inoculation of hepatoma cells and treated with fibrinolytic enzyme before and after PH. The animals were sacrificed 11 days after PH with their liver metastasis analyzed. Results The concentration of fibrinogen(Fbg) and the platelet aggregation rate(PLT) were significantly higher in mice after single PH(P=0.018,P=0.012,respectively),indicating that the coagulation activity is higher. The partial thromboplastin time(APTT) and prothrombin time(PT) were obviously longer(P=0.007,P=0.002) due to exhaust of coagulation factors. The coagulation activity after treatment with fibrinolytic enzyme almost returned to its normal level except for PT,and remarkable metastases were less after treatment than before treatment with fibrinolytic enzyme(P=0.003). Conclusion Hyper-coagulation activity after PH is correlated with increased liver metastasis.

     

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