干细胞加速健康肝组织再生

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干细胞加速健康肝组织再生 研究人员首次利用成体骨髓干细胞再生出健康的人类肝脏组织。详细研究内容刊登于4月《Radiology》。肝脏发生大规模、急性癌变的肝癌患者，不能接受外科手术治疗，因为摘除癌组织后留下的肝脏太少，不足以维持生命。
肝脏发生大规模、急性癌变的肝癌患者，不能接受外科手术治疗，因为摘除癌组织后留下的肝脏太少，不足以维持生命。德国杜塞尔多夫大学（Heinrich-Heine-University Düsseldorf）研究人员利用成体骨髓干细胞快速再生出健康肝脏组织，帮助这些患者接受外科手术。

  文章共同作者Günther Fürst说：“我们的研究结果提示，肝癌患者自身骨髓来源的肝脏干细胞，能够加速肝脏再生。”

  门静脉栓塞术（portal vein embolization，PVE）是一种辅助肝组织再生的技术，抑制血液流向受损肝脏，疏导血液流向健康组织，促进肝脏生长。从患者髋骨中提取的骨髓干细胞，注入肝脏后也能帮助肝脏再生。此次实验中，研究人员检测PVE和肝脏注射骨髓干细胞注射的联合技术的效果。

  参与实验的13名肝脏恶性肿瘤患者（不能接受外科手术治疗，因为治疗后留下的肝组织不到原来的25％）中，6名患者接受PVE和骨髓干细胞注射联合治疗，7名患者只接受PVE治疗。研究人员在治疗前和治疗5周后，对患者进行电脑断层（Computed tomography ，CT）扫描以确定肝脏生长程度。

  结果显示，接受联合治疗的患者与单独接受PVE治疗的患者相比，肝脏生长速度和新生肝脏体积都高出一倍，结果前者比后者接受外科摘除肿瘤手术的时间平均提前了18天。

  文章共同作者Jan Schulte am Esch认为，成体干细胞也可是其它慢性或急性肝损伤组织再生的一个候选治疗手段。

部分英文原文：

Radiology 2007;243:171-179.
Portal Vein Embolization and Autologous CD133+ Bone Marrow Stem Cells for Liver Regeneration: Initial Experience1
Günter Fürst, MD, Jan Schulte am Esch, MD, Ludger W. Poll, MD, Stefan B. Hosch, MD, L. Benjamin Fritz, MD, Michael Klein, MD, Erhard Godehardt, MD, Andreas Krieg, MD, Britta Wecker, Volker Stoldt, MD, Marcus Stockschl鋎er, MD, Claus F. Eisenberger, MD, Ulrich M鰀der, MD and Wolfram T. Knoefel, MD

1 From the Institute of Diagnostic Radiology (G.F., L.W.P., L.B.F., B.W., U.M.) and Departments of General Surgery (J.S.a.E., S.B.H., A.K., C.F.E., W.T.K.), Cardiothoracic Surgery (M.K., E.G.), and Hemostaseology and Transfusion Medicine (V.S., M.S.), Heinrich-Heine-University of Duesseldorf, Moorenstr 5, 40225 Duesseldorf, Germany. Received April 7, 2006; revision requested June 5; final revision received June 19; accepted August 24. Address correspondence to L.B.F. (e-mail: ben@fritz.md ).


Purpose: To prospectively evaluate the effectiveness of portal vein embolization (PVE) and CD133+ bone marrow stem cell (BMSC) administration to the liver, compared with PVE alone, to augment hepatic regeneration in patients with large hepatic malignancies.

Materials and Methods: The study was approved by the institutional ethics committee; informed consent was obtained. Thirteen patients underwent PVE of liver segments I and IV-VIII to stimulate hepatic regeneration prior to extended right hepatectomy. In six patients (three men, three women; mean age, 61 years; range, 46–72 years) with a future liver remnant volume (FLRV) below 25% and/or limited quality of hepatic parenchyma, PVE alone did not promise adequate proliferation. These patients underwent BMSC administration to segments II and III (group I). In seven patients (three men, four women; mean age, 69 years; range, 63–75 years) with an FLRV below 25%, PVE alone was performed (group II). Two radiologists blinded to patients' identity and each other's results measured liver and tumor volumes with helical computed tomography. Absolute, relative, and daily FLRV gains were compared by using the t test or the Wilcoxon test.

Results: The increase of the mean absolute FLRV in group I from 239.3 mL ± 103.5 (standard deviation) to 417.1 mL ± 150.4 was significantly higher than that from 286.3 mL ± 77.1 to 395.9 mL ± 94.1 in group II (P = .049). The relative gain of FLRV after PVE in group I (77.3% ± 38.2) was significantly higher than that in group II (39.1% ± 20.4) (P = .039). The daily hepatic growth rate in group I (9.5 mL/d ± 4.3) was significantly superior to that in group II (4.1 mL/d ± 1.9) (P = .03). Time to surgery was 27 days ± 11 in group I and 45 days ± 21 in group II (P = .057).

Conclusion: In patients with malignant liver lesions, the combination of PVE with CD133+ BMSC administration substantially increased hepatic regeneration compared with PVE alone.