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Necrosis and Apoptosis in Hepatocellular Carcinoma Following Low-Dose Versus High-Dose Preoperative Chemoembolization

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Abstract

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.

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Acknowledgments

The study was supported by the National Nature and Science Foundation of China (No. 30670612) and the Nature and Science Foundation of Guangdong province (No. 05300926). The authors thank Dr. John A. Kaufman, Dotter Interventional Institute, Oregon Health & Science University, Portland, for his assistance in preparation of the manuscript.

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  1. Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou North Road, Guangzhou, Guangdong, 510515, China

    Wei Lu, Yan-Hao Li, Xiao-Feng He, Jian-Bo Zhao, Yong Chen & Que-Lin Mei

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  1. Wei Lu
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  2. Yan-Hao Li
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  3. Xiao-Feng He
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Correspondence to Wei Lu or Yan-Hao Li.

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Lu, W., Li, YH., He, XF. et al. Necrosis and Apoptosis in Hepatocellular Carcinoma Following Low-Dose Versus High-Dose Preoperative Chemoembolization. Cardiovasc Intervent Radiol 31, 1133–1140 (2008). https://doi.org/10.1007/s00270-008-9379-4

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  • DOI: https://doi.org/10.1007/s00270-008-9379-4

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