Necrosis and apoptosis in hepatocellular carcinoma following low-dose versus high-dose preoperative chemoembolization.
Our purpose was to study necrosis and apoptosis of hepatocellular carcinoma (HCC) cells after preoperative transcatheter arterial chemoembolization (TACE) with use of low-dose and high-dose anticancer drugs in HCCs. Fifty-four patients with advanced but surgically resectable HCC were studied. Thirty-four patients who elected to undergo preoperative superselective TACE were randomized to low- and high-dose TACE. Patients in group A (n = 16) received low-dose anticancer drugs: 2 mg mitomycin C (MMC), 10 mg epirubicin (EPI), and 100 mg carboplatin (CBP). Patients in group B (n = 18) were given high doses of anticancer drugs (10 mg MMC, 40 mg EPI, and 300 mg CBP). Hepatic resection was subsequently performed. Group C comprised 20 patients who underwent resection without TACE. In all patients the necrosis rates and apoptosis index of tumor cells were evaluated by pathologic examinations and terminal deoxynucleotidyl transferase-mediated nick-end labeling assay. There was no significant difference between group A and group B in tumor response (p [ 0.05) after TACE. Necrosis rates in groups A, B, and C were 88.4 +/- 11.1%, 87.1 +/- 12.5%, and 7.3 +/- 3.5%, respectively. There was no significant difference between group A and group B (p [ 0.05), while statistical difference was found between group A and group C (p \ 0.001) and between group B and group C (p \ 0.001). Apoptosis indexes in the three groups were 11.0 +/- 4.0%, 10.7 +/- 3.9%, and 5.6 +/- 2.6%, respectively. Statistical difference exhibited between group A and group C (p \ 0.001) and group B versus group C (p \ 0.001). No significant difference was observed between group A and group B (p [ 0.05). In conclusion, superselective TACE with low- and high-dose chemotherapeutic agents induced similar degrees of cellular apoptosis and necrosis.
Lu
Wei
W
Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou North Road, Guangzhou, Guangdong 510515, China. dr-lw@163.com
Li
Yan-Hao
YH
He
Xiao-Feng
XF
Zhao
Jian-Bo
JB
Chen
Yong
Y
Mei
Que-Lin
QL
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis; D016190:Carboplatin / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009336:Necrosis; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D015251:Epirubicin; D016685:Mitomycin; D016190:Carboplatin