新型血管内射频消融导管联合球囊扩张治疗门静脉癌栓的应用基础研究

Hepatocellular carcinoma(HCC) is one of the most common malignant tumors,the death rate has become second malignant tumor in China due to HCC.Liver cancer with main portal vein tumor thrombus(PVTT) has incidence of high and intractable characteristics. At present, some therapy methods are not ideal.So,a new effective therapy method is needed.Recent report,radiofrequency ablation(RFA)can treat PVTT and obtain certain effect. However,traditional radiofrequency ablation has a straight and inflexible radiofrequency needle,which don not enter into the blood vessel and injures the normal structure of portal blood and surrounding biliary tract. So, this radiofrequency needle is not fit for treatment main portal vein tumor thrombus. The novelty of this topic is that a new radiofrequency catheter with soft and plasticity is used to treatment main portal vein tumor thrombus,which can enter into the blood vessel and don not injure the vascular wall and surrounding tissue. This topic will use this new radiofrequency catheter combine with balloon inflation to treat the animal models' main portal vein and/or main branches portal vein tumor thrombus,meanwhile,the effect, impact on vascular wall and adjacent tissue,and recanalization of portal vein will be observed, which may provide a new idea for portal vein tumor thrombus therapy.

原发性肝细胞癌(HCC)是常见的恶性肿瘤之一，其死亡率居我国恶性肿瘤的第二位。门静脉癌栓（PVTT）在肝细胞癌中发生率高，治疗棘手，目前开展的几种治疗方法适应证有限、疗效不理想，急需寻找新的有效方法。近期有报道射频消融（RFA）治疗PVTT，取得了一定疗效，但由于使用传统硬金属直的射频针，不能弯曲，不能长距离进入血管，对门脉血管及周围胆道等正常组织损伤大，不适用于门脉主干或门脉较长癌栓。本课题新颖之处是利用新研制的血管内射频导管对门静脉癌栓进行射频治疗，新型血管内射频导管是柔软，可塑性的，可以进入血管内进行射频，对血管壁及周围组织无明显影响。本课题拟应用新型射频导管对动物模型门静脉主干和/或主支癌栓进行射频治疗,联合球囊扩张,观察门脉癌栓的疗效、对血管壁及邻近组织的影响、门静脉再通情况，为临床治疗门静脉癌栓提供新思路。

肝细胞癌（HCC）是世界上第五大最常见的恶性肿瘤，在肿瘤相关致死性原因中位列第三位。中国肝癌发病率明显高于其他国家，约占全球新发病例的55％。因肝癌死亡的人数占全球的45%。由于HCC早期症状隐匿，患者就诊时多属中晚期，很多患者就诊时已出现癌栓。门静脉癌栓（PVTT）在肝细胞癌中发生率高，治疗棘手，目前开展的几种治疗方法适应证有限、疗效不理想，急需寻找新的有效方法。近期有报道射频消融（RFA）治疗PVTT，取得了一定疗效，但由于使用传统硬金属直的射频针，不能弯曲，不能长距离进入血管，对门脉血管及周围胆道等正常组织损伤大，不适用于门脉主干或门脉较长癌栓。本课题利用新研制的血管内射频导管对动物正常门静脉、球囊阻断后的门静脉和模拟癌栓的门静脉进行射频治疗。结果表明门静脉血流通畅时，设定消融功率5w，时间6min是安全的；若将门静脉主干阻塞或模拟癌栓的门静脉，消融功率5w，时间减为3min以内是安全的，并有可能获得毁损局部瘤栓的效果。初步证实Habib ™VesOpen™导管消融门脉癌栓安全有效。