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Percutaneous ultrasound-guided ablation of BW7756-hepatoma using ethanol or acetic acid in a rat model.

Zardi EM, Borzomati D, Cacciapaglia F, Picardi A, Valeri S, Bianchi A, Galeotti T, Coppolino G, Coppola R, Afeltra A - BMC Gastroenterol (2007)

Bottom Line: Our results show that there is no significant difference in the percentage of tumor necrosis between two local ablation methods in spite of the different dosages used.However, mortality in the PAI-treated group was greater than in PEI-treated group, presumably due to greater acetic acid systemic diffusion and its metabolic side effects.This could be the reason why some human studies have concluded similar or even better safety and efficacy with PAI compared to PEI.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Medicine Campus Bio-Medico University, Rome, Italy. e.zardi@unicampus.it

ABSTRACT

Background: To compare tumor necrosis in hepatoma induced in rats by a single percutaneous injection of ethanol (PEI) or acetic acid (PAI).

Methods: BW7756 hepatomas of 1 mm3 were implanted in the liver of 40 male healthy rats. After 14 days, the 36 surviving rats were treated, in a single session, by ultrasound-guided injection of 300 microl of 95% ethanol (n = 17) or 100 microl of 50% acetic acid (n = 19). They were sacrificed 14 days after treatment and explanted tumoral livers were examined. The same PAI procedure was repeated on 13 additional rats to exclude a suspected occurrence of technical failures during the experiment, due to a surprisingly high rate of deaths within 30 minutes after PAI.

Results: Four rats died within four days after tumor implantation; after PEI, 1/17 (6%) died, whereas after PAI 9/19 (47%) died. The remaining 26 rats, after 14 days post-percutaneous ablation, were sacrificed. Gross and microscopic examinations showed that the hepatoma's nodules treated with PEI had 45.3 +/- 19.4% tumor necrosis compared to 49 +/- 23.3% (P = NS) for those treated with PAI. Complete tumor necrosis was not found in any animal. Peritoneal invasion was present in 4/16 (25%) and 2/10 (20%) rats treated with PEI or PAI, respectively (P = NS). Autopsy was performed in the 5 additional rats that died within 30 minutes after PAI.

Conclusion: Our results show that there is no significant difference in the percentage of tumor necrosis between two local ablation methods in spite of the different dosages used. However, mortality in the PAI-treated group was greater than in PEI-treated group, presumably due to greater acetic acid systemic diffusion and its metabolic side effects. In human subjects, HCC occurs in the setting of cirrhosis, where the non-tumoral tissue is firmer than the tumor structure, with consequent reduction of drug diffusion. This could be the reason why some human studies have concluded similar or even better safety and efficacy with PAI compared to PEI.

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[A] Normal hepatocytes (a) and hepatoma cells (b). [B] Over 60% of field is occupied by perivascular (v) viable tumor cells; the left side is occupied by necrosis with cellular debris (c).
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Figure 3: [A] Normal hepatocytes (a) and hepatoma cells (b). [B] Over 60% of field is occupied by perivascular (v) viable tumor cells; the left side is occupied by necrosis with cellular debris (c).

Mentions: The calculated percentage of necrosis produced with the injection of 300 μl of 95% ethanol was 45.3 ± 19.4%, whereas with the injection of 100 μl of 50% acetic acid was 49 ± 23.3% (P = NS) (Figure 2). There were no differences evident in the necrosis determined by acetic acid or ethanol. Histological changes after injection of either agent determined areas of reduced cell number with degeneration of cytoplasmic and nuclear components and cellular debris (Figure 3), intermingled with viable neoplastic cells localized in perivascular and central areas of the hepatoma (Figure 4).


Percutaneous ultrasound-guided ablation of BW7756-hepatoma using ethanol or acetic acid in a rat model.

Zardi EM, Borzomati D, Cacciapaglia F, Picardi A, Valeri S, Bianchi A, Galeotti T, Coppolino G, Coppola R, Afeltra A - BMC Gastroenterol (2007)

[A] Normal hepatocytes (a) and hepatoma cells (b). [B] Over 60% of field is occupied by perivascular (v) viable tumor cells; the left side is occupied by necrosis with cellular debris (c).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2175504&req=5

Figure 3: [A] Normal hepatocytes (a) and hepatoma cells (b). [B] Over 60% of field is occupied by perivascular (v) viable tumor cells; the left side is occupied by necrosis with cellular debris (c).
Mentions: The calculated percentage of necrosis produced with the injection of 300 μl of 95% ethanol was 45.3 ± 19.4%, whereas with the injection of 100 μl of 50% acetic acid was 49 ± 23.3% (P = NS) (Figure 2). There were no differences evident in the necrosis determined by acetic acid or ethanol. Histological changes after injection of either agent determined areas of reduced cell number with degeneration of cytoplasmic and nuclear components and cellular debris (Figure 3), intermingled with viable neoplastic cells localized in perivascular and central areas of the hepatoma (Figure 4).

Bottom Line: Our results show that there is no significant difference in the percentage of tumor necrosis between two local ablation methods in spite of the different dosages used.However, mortality in the PAI-treated group was greater than in PEI-treated group, presumably due to greater acetic acid systemic diffusion and its metabolic side effects.This could be the reason why some human studies have concluded similar or even better safety and efficacy with PAI compared to PEI.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Medicine Campus Bio-Medico University, Rome, Italy. e.zardi@unicampus.it

ABSTRACT

Background: To compare tumor necrosis in hepatoma induced in rats by a single percutaneous injection of ethanol (PEI) or acetic acid (PAI).

Methods: BW7756 hepatomas of 1 mm3 were implanted in the liver of 40 male healthy rats. After 14 days, the 36 surviving rats were treated, in a single session, by ultrasound-guided injection of 300 microl of 95% ethanol (n = 17) or 100 microl of 50% acetic acid (n = 19). They were sacrificed 14 days after treatment and explanted tumoral livers were examined. The same PAI procedure was repeated on 13 additional rats to exclude a suspected occurrence of technical failures during the experiment, due to a surprisingly high rate of deaths within 30 minutes after PAI.

Results: Four rats died within four days after tumor implantation; after PEI, 1/17 (6%) died, whereas after PAI 9/19 (47%) died. The remaining 26 rats, after 14 days post-percutaneous ablation, were sacrificed. Gross and microscopic examinations showed that the hepatoma's nodules treated with PEI had 45.3 +/- 19.4% tumor necrosis compared to 49 +/- 23.3% (P = NS) for those treated with PAI. Complete tumor necrosis was not found in any animal. Peritoneal invasion was present in 4/16 (25%) and 2/10 (20%) rats treated with PEI or PAI, respectively (P = NS). Autopsy was performed in the 5 additional rats that died within 30 minutes after PAI.

Conclusion: Our results show that there is no significant difference in the percentage of tumor necrosis between two local ablation methods in spite of the different dosages used. However, mortality in the PAI-treated group was greater than in PEI-treated group, presumably due to greater acetic acid systemic diffusion and its metabolic side effects. In human subjects, HCC occurs in the setting of cirrhosis, where the non-tumoral tissue is firmer than the tumor structure, with consequent reduction of drug diffusion. This could be the reason why some human studies have concluded similar or even better safety and efficacy with PAI compared to PEI.

Show MeSH
Related in: MedlinePlus