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目的 探讨射频消融 (RFA)对兔VX2 肝脏移植瘤的治疗机制。方法 通过VX2 肿瘤组织混悬液肝内注入法建立兔肝脏肿瘤模型 ,随机分为实验组及对照组 ,分别予以RFA治疗及假性处理 ,于治疗结束后 0、12h、1、2、4、8、16d共 7个时间点分别切取肿瘤中心组织及边缘组织为检测标本 ,进行HE染色、透射电镜检查并运用TUNEL法检测肿瘤细胞凋亡情况。结果 治疗组毁损区边缘部组织中有大量阳性细胞 ,中心部分亦有较多的阳性细胞 ,两者凋亡细胞指数差异非常显著 (P <0 .0 1)。对照组标本中仅发现极少数阳性细胞 ,且其中心区与边缘区无统计学差异 ,其凋亡细胞指数与治疗组标本相比 ,差异均非常显著 (P <0 .0 1)。于不同时间点观察 ,治疗组细胞凋亡高峰在 2 4h左右 ,而对照组细胞凋亡则无明显时间分布特征。结论 诱导肿瘤细胞凋亡是射频消融治疗肝脏恶性肿瘤的一项重要机制。其发生的部位主要是肿瘤周边区 ,时间高峰在RFA作用后 2 4h左右。
Objective To investigate the therapeutic mechanism of radiofrequency ablation (RFA) on VX2 liver xenografts in rabbits. Methods Rabbit liver tumor model was established by intra-hepatic injection of VX2 tumor tissue suspension and randomly divided into experimental group and control group. RFA and pseudo-treatment were given respectively. At 0, 12h, 1, 2, 4, At 8 and 16 days, the tumor tissues and margins were removed from the tumor tissues at 7 time points. HE staining, transmission electron microscopy and TUNEL were used to detect the apoptosis of tumor cells. Results There were a large number of positive cells in the marginal part of the damaged area in the treatment group and more positive cells in the central part. There was a significant difference in apoptotic index between the two groups (P <0.01). Only a few positive cells were found in the control group, and there was no significant difference between the central and peripheral regions. The apoptotic index was significantly higher than that in the treated group (P <0.01). Observed at different time points, the peak of apoptosis in the treatment group was about 24 h, while the apoptosis in the control group showed no obvious temporal distribution. Conclusion Induction of tumor cell apoptosis is an important mechanism of radiofrequency ablation in the treatment of hepatic malignancies. The site of its occurrence is mainly the tumor peripheral area, the peak time after RFA role around 24h.