Influence of the angioarchitecture of the metastatic liver tumors on the selection of the microspheres diameter

¹Astana Medical University, Astana, Kazakhstan

²National Scientific Center of Oncology and Transplantation, Astana, Kazakhstan

³Medical Centre hospital of the President’s affairs administration of the Republic of Kazakhstan

The thesis is devoted to the study of the morphology of biopsy specimens of patients with unrespectable metastatic liver cancer. The possibilities of the microspheres application according to the angioarchitecture options of the tumors are investigated.

Objective: To study the possible applications and uses of various chemodrug- loaded microspheres according to the morphological variants of the tumor angioarchi-tecture.

Material and Methods: We analyzed the results of the morphometric study of three study -groups of patients with liver metastases. Among these 10 patients (41%) had metastasized colorectal cancer, 8 pts (33%) metastases of gastric cancer and esophageal, 6 pts (26%) had a pancreatic cancer. The tumors diameter ranged from 3 cm to 7 cm. The samples of liver tissue biopsies were fixed in 10% buffered formalin solution (pH 6,8-7), dehydrated in alcohols of increasing concentrations, embedded in paraffin blocks, sectioned, of which a thickness of 3-5 microns followed by staining with hematoxylin and eosin. Each biopsy of the liver we determined by the volume fraction of the vessels of portal tracts, which had the tumor embolic agents. Calculation was performed using the automated system, using software VideoTesT Morphology 5.0 (Axioskop 40 FL, Carl Zeiss).

Results: Morphological picture of metastatic colorectal cancer was presented by hypervascular masses with a diameter of vessels from 30 to 110 μm from the corecenter to the periphery of the entities with the chaotic arrangement. Metastasis of cancer of the stomach and pancreas had heterogeneous vasculature with areas of hyperand hypo vascularization, with diameters ranging from 20 to 130 μm. With considering of the masses angioarchitec-ture we theoretically selected the appropriate size of the chemoloaded microspheres for target chemoembolization (TACE). In view of the morphological pattern, we assumed that the smaller the diameter, the more efficiently will chemotherapeutic and ischemic effects of the procedure. In the presence of zones hypervascularization represented by small arteries to the target occlusion prefer to use is loaded with calibrated microspheres smallest diameter.

Conclusion. The TACE with chemoloaded microspheres is one of the methods for the palliative treatment of liver tumors, which allows to stabilize the patient status and improve the quality of life. In theory, the choice of the size of the diameter microspheres should be based on the features of the tumors angioarchitecture.. The microspheres diameter should choose depending on the morphology and diameter of vascular tumor structure. It is advisable to use a precisely calibrated microspheres of 40μm in accordance with the diameter of the vessels from the tumor center to the periphery localisation. Therefore, the clinical effect of this technique of choice depending on angioarchitecture before the end is not completely explored, but it will be studied and reported in the future.

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