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KMID : 0350519920450041457
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Journal of Catholic Medical College
1992 Volume.45 No. 4 p.1457 ~ p.1470
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The Effects of Hepatic Arterial Ligation and Hepatic Irradiation on the Liver in Rats
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Abstract
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The majority of the hepatomas (both primary and metastatic) are advanced at the time of detection involving both lobes and presenting in multiple foci, making them unresectable.
So far, available chemotherapeutic agents have consistently failedto show the response rate of over 15-25%. Recently, transcatheter hepatic arterial embolization has been used for palliation of unresectable liver tumors. The exclusive arterial
dependance of the liver tumors accounts for selective necrosis of hepatic tumors caused by hepatic dearterialization(surgical ligation or embolization of hepatic artery). But, hepatic arterial embolization does not often apply to the one who has
obstructive jaundice and/or portal vein thrombosis because of increasing damage to the remaining liver cells.
Hepatic irradiation for liver tumors is occasionally successful but inconsistent with long term response or improved survivals.
This study was carried out to investigate how hepatic arterial ligation and irradiation influence on the normal liver tissue, simulated the situation of combined modalities with hepatic arterial embolization and external irradiation of whole
liver
for
the advanced liver tumors.
Ninety Sprague-Dawley rats weighing 150 to 200g were divided into two major groups: hepatic artery ligation group(n=45) and non ligation group(n=45). Each group was further divided into 3 subgroups depending on the daily radiation doses in terms
of
0
cGy, 250 cGy and 350 cGy. Each subgroup was composed of 15 rats the irradiation was performed 3 times per week during the period of 4 weeks, with the cumulative doses up to cGy, 3000 cGy(12 fractionations/25 days), and 4200 cGy(12
fractionations/25
days) using a 6 MV linear accelerator. Weekly blood sampling was done from the retro-orbit by the capillary method, followed by assay for SGPT, alkaline phosphatase, and copper in serum. In each subgroup, two animals were sacrificed every other
week to
collect the liver specimen for the purpose of pathologic study.
@ES The results were as follows:
@EN 1. The values of SGPT and alkaline phosphatase in the iradiated groups were significantly increased with time(P<0.05). But there were no significant difference among subgroups(P<0.05).
2. The values of SGPT and alkaline phosphatase in the hepatic artery ligation groups were also significantly increased with time(P<0.05) but the significant difference was found among subgroups (P<0.05).
3. The values of SGPT and alkaline phosphatase in the irradiated groups were not significantly different between the ligation group and nonligation group(P<0.05).
4. The values of serum copper in both the irradiation and the hepatic artery ligation groups were significantly higher than those of the control group(non-irradiation and non-ligation)(P<0.05).
5. Histologically, some spotty necrosis and infiltration of mononuclear cells were seen immediately after hepatic irradiation in both the hepatic artery ligation and non-ligation groups. On the 30th postirradiation day, necrosis of some
hepatocytes and
lympho-histiocytic and infiltration of plasma cell were noted around the portal tract. Regardless of ligation the histologic changes were much the same as the irradiation groups.
In conclusion, hepatic artery ligation and/or irradiation had no significant influence on the hepatocellular responses, suggesting that the hepatocellular response to hepatic artery ligation (embolization) along with whole liver irradiation may
not
be a
critical condition. The serum copper was significantly increased by irradiation and/or hepatic artery ligation, suggesting that this test can be used as an index of the hepatocellular damage caused by irradiation and/or hepatic artery ligation.
This
test needs further studies including clinical investigation.
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KEYWORD
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