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The effect of absolute ethanol embolization on microvessels and expression of basic fibroblast growth factor and its receptor in renal cell carcinoma
ABSTRACT To study the change of microvessels, bFGF and its receptor FGF-R of renal cell carcinoma after embolization with absolute ethanol. 46 cases of renal cell carcinomas proved by surgery and pathology were studied, 36 of them were embolized by absolute ethanol and 10 were treated with surgical resection alone.Streptavidin-biotinperoxidase-complex (SP) immunohistochemical staining with rabbit anti-factor Ⅷ related antigen polyclonal antibody, bFGF rabbit polyclonal and FGF-R mousc monoclonal in all specimens, then study on the correlation between two groups.The results showed that microvessels counts of embolization group were significantly higher than that of the simply surgery group (P<0.001);The expression of bFGF and FGF-R was consistent ,postive rate was 55.6% in embolization group, 60% in surgery group.There was no significant difference between the two groups (P>0.05).It is suggested that embolization with absolute ethanol can decrease the microvessels counts of renal cell carcinoma,and may decrease the probability of metastasis through blood.
KEY WORDS renal neoplasms angiogenesis basic fibroblast growth factor embolization interventional radiology
肾细胞癌约占成年人肾脏恶性肿瘤的85%。早期肾癌主要依靠手术切除治疗，中晚期肾癌确诊时有25%～30%已发生局部或远处转移，手术难度较大。有关肾癌介入治疗国内外均有报道，但是关于肾动脉栓塞对肿瘤血管生成影响的研究尚未见报道。本研究应用免疫组织化学方法检测肾癌无水乙醇栓塞后，微血管数目和血管生成因子—碱性成纤维生长因子(bFGF)及其受体(FGF-R)的表达，旨在探讨无水乙醇栓塞对肾癌血管生成的影响。
1 材料和方法
1.1 临床资料 选用本院1993～1998年间经无水乙醇栓塞的肾癌标本36例，并以同期单纯手术切除的肾癌标本10例作为对照。36例无水乙醇栓塞后肾癌中，男性23例，女性13例，年龄37～77岁，平均59岁。按Robson病理分期：Ⅰ期15例，Ⅱ期6例，Ⅲ期6例，Ⅳ期9例。其中透明细胞癌24例，颗粒细胞癌6例，混合细胞癌6例。肿瘤直径5～15cm，平均7.6cm。标本均经常规固定、包埋、切片。
1.2 栓塞方法 采用Seldinger技术行股动脉穿刺，引入导管后先行腹主动脉造影，以确定肿瘤供血动脉及肿瘤血供情况。选择患侧肾动脉造影，证实为肿瘤供血动脉后进行栓塞。所有病例均使用无水乙醇作为栓塞剂，栓至肾动脉主干以下分支全部闭塞，血流停滞。无水乙醇用量13～70ml，平均24.91ml。栓塞至手术时间为3～30d，平均5d。
1.3 染色方法 兔抗Ⅷ因子相关抗原多克隆抗体为Zymed公司产品，工作浓度1∶25；bFGF兔多克隆抗体(SC-79)和FGF-R鼠单克隆抗体(SC-276)为Santa Crus公司产品，工作浓度1∶20，SP试剂盒为Zymed公司产品，均购自北京中山生物技术有限公司。免疫组织化学染色采用SP法。
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