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目的探讨伽玛刀（γ-刀）治疗颅内肿瘤的形态学变化及其与临床的关系。方法应用光镜、电镜观察16例γ-刀照射后颅内肿瘤手术切除标本的病理形态学变化，其中星形细胞瘤7例，少突胶质细胞瘤2例；脑膜瘤2例；颅咽管瘤1例；血管母细胞瘤1例；垂体腺瘤1例和转移性腺癌2例。结果γ-刀照射后肿瘤中心和肿瘤边缘的瘤细胞及血管均出现不同程度的凝固性坏死，恶性肿瘤呈急性坏死，良性肿瘤呈延迟性坏死；边缘部位残留的瘤细胞较中心部位多，肿瘤旁脑组织中神经元、胶质细胞及血管均出现不同程度的损伤，但主要以胶质细胞损伤为显著。结论残留的瘤细胞是肿瘤复发的形态学依据，γ-刀对肿瘤旁脑组织的损伤与脑水肿的产生有密切关系。提示临床应注意选择适当的照射剂量及肿瘤大小，以防止肿瘤复发和预防脑水肿的发生。
Objective To investigate the morphological changes of intracranial tumors treated by Gamma Knife (γ-knife) and its clinical significance. Methods The pathological changes of 16 cases with intracranial tumors were observed by light microscope and electron microscope. There were 7 cases of astrocytoma, 2 cases of oligodendroglioma, 2 cases of meningioma, 1 case of tumor, 1 case of hemangioblastoma, 1 case of pituitary adenoma and 2 cases of metastatic adenocarcinoma. Results γ-knife irradiation tumor center and the edge of the tumor cells and blood vessels have varying degrees of coagulation necrosis, malignant tumor was acute necrosis, benign tumor was delayed necrosis; edge of residual tumor cells more than the central part of the tumor Parathyroid tissue neurons, glial cells and blood vessels have varying degrees of damage, but the main glial injury was significant. Conclusion The residual tumor cells are the morphological basis of tumor recurrence. The injury of tumor para-brain tissue by γ-knife is closely related to the occurrence of cerebral edema. Prompt attention should be given to choose the appropriate dose of radiation and tumor size to prevent tumor recurrence and prevent the occurrence of cerebral edema.