高强度聚焦超声联合超声造影剂消融肝脏VX2移植瘤的实验研究
The effect of HIFU ablation combined with UCA on normal tissue around VX2 liver tumor in rabbits
摘要 目的 探讨高强度聚焦超声(high intensity focused ultrasound,HIFU)联合超声造影剂(ultrasound contrast agents,UCA)治疗肝癌时的最适消融范围. 方法构建新西兰兔肝VX2移植肿瘤模型.51只模型兔分为3组:HIFU联合UCA沿肿瘤边缘消融肿瘤(A组)、消融肿瘤及肿瘤周围2 mm内的组织(B组)、消融肿瘤及周围4mm内的组织(C组).比较治疗后靶组织的病理情况、血清丙氨酸氨基转移酶(ALT)水平、肝内、肺及腹腔的转移情况以及生存期的差异.结果 HIFU联合UCA治疗后,各组靶区肿瘤组织均发生凝固性坏死;治疗后3 d、5 d,C组患者ALT显著升高,组间比较差异有统计学意义(F=12.933、18.37,均P<0.01),C组最高;治疗后14 d,B组、C组ALT降至正常,组间比较差异无统计学意义(F=0.043,P>0.05),A组ALT水平高于B组和C组(F=17.2,P<0.05).治疗后两周肝内、肺及腹腔转移率A组均明显高于B组和c组(分别x2=9.918、6.300、7.6701,均P<0.05),B组和C组差异无统计学意义(均P>0.05),平均生存期A组(29 4±5.4)与B组(48±13.6)、C组(51±12.1)差异均有统计学意义(P<0.05),B组和C组差异无统计学意义(P>0.643).结论 HIFU联合UCA在消融移植瘤周围组织2mm以上时可明显降低治疗后转移率,延长荷瘤兔的生存时间.
Abstract:
Objective To explore the optimized range of normal tissue ablation around the tumor by HIFU in combination with UCA for VX2 liver tumors in rabbits. Methods In this study,51 rabbit models with implanted fiver VX2 tumors were randomly divided into 3 groups:ablating the tumor only(group A)、ablating the tumor and 2 mm eircumferential normal tissue(group B)、and 4 mm normal tissue around the tumor(group C).After HIFU+UCA treatment,the pathology of the targeting tissues,the level of serum ALT,the metastases in the liver、lungs and abdominal cavity,and the survival time were compared with each other. Results After treatment coagulative necrosis was observed in all the target tissues.Serum ALT level between each two groups were statistically different on d3 and d5(F=12.933、18.37,P<0.01、<0.01),and the level of ALT in group C was the hightest.The ALT level in group A was significantly higher than group B or group C on the 14th day(F=17.2,P<0.01).Metastases in group A was significantly higher than group B or group C,and there were no statistically different between group B and C (P=0.353、0.332、0.380).The survival time both in group B and group C were significantly longer than group A(48±13.6,51±12.1 vs 29±5.4),and there were no statistically difference between group B and C(P>0.05). Conclusions Tumor eradication can be significantly promoted when 2mm normal liver tissue around the tumor is ablated by HIFU+UCA.
Author: FAN Zhi-yong SONG Zhen-shun ZHENG Wei HUANG Sheng ZHANG Fu-qin LUO Wen ZHOU Xiao-dong
作者单位: 第四军医大学西京医院肝胆外科,西安,710032 第四军医大学西京医院超声诊断科,西安,710032
刊 名 中华普通外科杂志 ISTICPKU
年,卷(期): 2008, 23(5)
分类号: R73
机标分类号: H31 R73
在线出版日期: 2008年7月1日