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目的 探讨高强度聚焦超声 (HIFU )对乳腺癌实验性治疗的可行性和有效性。方法 应用重庆医科大学医学超声工程研究所自行研制生产的JC型高强度聚焦超声肿瘤治疗系统对 2 3例拟行改良根治手术乳腺癌患者术前 1～ 2周行HIFU治疗。术后测定HIFU治疗靶区大小 ,并对靶区组织作光镜、电镜和NADH 黄递酶组织化学检查。结果 ①乳腺癌包块直径平均 ( 3.10± 0 .79)cm ,体积 ( 16 .80± 13.40 )cm3 ;HIFU靶区直径 ( 6 .2 4± 0 .2 6 )cm ,体积 ( 12 4.49± 47.84)cm3 ,靶区边界超过乳腺癌包块 1.5～ 2 .2cm[平均 ( 1.80± 0 .5 8)cm]。无论是靶区径线还是体积均显著大于乳腺癌包块 ( P <0 .0 0 1) ,靶区超范围完全覆盖乳腺癌包块。②HIFU靶区内多数乳腺癌细胞呈典型凝固性坏死 ;部分肿瘤切片行常规HE染色显示细胞形态无明显变化 ,难以判断是否坏死 ,但电镜和NADH 黄递酶组织化学检查证实其仍为坏死细胞 ,即非典型坏死 (NTN)。结论 ①HIFU靶区完全覆盖乳腺癌包块 ,符合外科手术原则 ,HIFU治疗乳腺癌是可行的 ;②HIFU靶区内乳腺癌细胞形态不一致 ,但都是坏死细胞 ,HIFU治疗乳腺癌是有效的。
Objective To investigate the feasibility and effectiveness of high intensity focused ultrasound (HIFU) in the experimental treatment of breast cancer. Methods The JC type high intensity focused ultrasound oncology treatment system developed by the Institute of Medical Ultrasound Engineering of Chongqing Medical University was used to perform HIFU treatment in 23 cases of patients with breast cancer who underwent radical radical operation 1 to 2 weeks before operation. The size of target area for HIFU treatment was determined after operation, and histopathological examination of target tissue was performed by light microscope, electron microscope and NADH diaphorase. Results ① The diameter of breast mass was (3.10 ± 0.79) cm, the volume was (16.8 ± 13.40) cm3, the diameter of HIFU target was (6.24 ± 0.226) cm and the volume was (12.449 ± 47.84) ) cm3, and the target area exceeded the breast cancer mass by 1.5-2.2cm [mean (1.80 ± 0.58) cm]. Both the diameter of the target area and the volume were significantly larger than the mass of breast cancer (P <0.01), the target area over the complete coverage of breast mass. ② The majority of breast cancer cells in HIFU target area showed typical coagulation necrosis. Some of the tumor sections showed no obvious changes in cell morphology by conventional HE staining, it was difficult to determine whether they were necrosis. However, electron microscopy and NADH diaphysis histochemical examination confirmed that they were still necrotic cells, That atypical necrosis (NTN). Conclusions ① The HIFU target area completely covers the mass of breast cancer, which is in line with the principle of surgery. HIFU treatment of breast cancer is feasible. ② The morphology of breast cancer cells in HIFU target area is inconsistent, but they are both necrotic cells. HIFU is effective in treating breast cancer.