超聲與增強CT評價肝癌射頻消融術(shù)療效的相關(guān)性及射頻消融術(shù)對兔肝殘余腫瘤生物學行為的影響
發(fā)布時間：2018-08-25 14:41
【摘要】：第一部分超聲與增強CT評價肝癌射頻消融術(shù)療效的相關(guān)性分析 目的：探討超聲與增強CT評價肝癌射頻消融術(shù)（radio frequency ablation，RFA）治療效果的相關(guān)性。 方法：選取大連醫(yī)科大學附屬第二醫(yī)院2008年1月-2012年12月124例臨床資料完整且臨床確診為肝癌的患者，原發(fā)灶108個，轉(zhuǎn)移灶40個，共148個病灶。分別對124例患者于RFA治療前、RFA治療后1個月、3個月行超聲及增強CT檢查，分析治療前后消融灶聲像圖改變與CT掃描結(jié)果的相關(guān)性。 結(jié)果：與術(shù)前對比，根據(jù)病灶損毀程度及時間變化，超聲與CT評價消融區(qū)療效的影像表現(xiàn)呈正相關(guān)性（P＜0.05）。 結(jié)論：超聲與CT雖各具優(yōu)點，但超聲操作簡單、經(jīng)濟、耗時少、創(chuàng)傷小、并發(fā)癥少，可作為RFA療效評價的首選方法。 第二部分兔肝VX_2腫瘤射頻消融術(shù)后殘癌中caspase-8表達變化的意義 目的：探討兔肝臟VX_2腫瘤射頻消融術(shù)（radio frequency ablation，RFA）后殘余瘤組織中天冬氨酸特異性半胱氨酸蛋白酶（caspase-8）表達變化的意義。 方法：實驗兔28只，VX_2荷瘤兔3只，傳代2只，肝內(nèi)接種23只。從荷瘤兔腿部切取腫瘤周邊生長旺盛的魚肉樣組織，剪成大小約1mm3的瘤塊，超聲引導(dǎo)下將VX_2瘤粒接種于23只已麻醉成功的實驗兔肝臟內(nèi)，2周后制成兔肝臟VX_2腫瘤動物模型。隨機抽出3只行超聲檢查，明確肝內(nèi)出現(xiàn)陽性病灶，處死動物，行HE染色，觀察鏡下細胞形態(tài)，以確定腫瘤是否接種成功。將成功制成的兔肝臟腫瘤模型隨機分為5組，A組3只，為對照組，不行RFA治療；將剩余20只行RFA治療，損毀范圍約為腫瘤最大半徑的2/3，人為造成腫瘤組織殘余。按治療后不同時間點分為術(shù)后0h組（B組）5只、術(shù)后1周組（C）組5只、術(shù)后2周組（D組）5只和術(shù)后4周組（E）組5只。經(jīng)超聲檢查后分別將荷瘤兔處死，應(yīng)用免疫組化方法檢測4組治療后兔肝臟VX_2腫瘤殘余瘤組織中及未經(jīng)治療組中caspase-8的表達情況。 結(jié)果： 1.造模結(jié)果 接種后2~4w行超聲檢查，23只實驗兔全部接種成功。超聲顯示肝臟內(nèi)見圓形或類圓形的低回聲結(jié)節(jié)，大小1.5±0.5cm，邊界清晰，無包膜回聲，，血流豐富，并探及動脈血流。隨機抽出3只處死后行HE染色，觀察癌細胞呈巢狀分布，體積大，排列不規(guī)則，胞核大且深染，示肝內(nèi)接種成功。 2.RFA術(shù)后超聲顯示 術(shù)后0h腫瘤毀損部呈不規(guī)則強回聲，邊界不清晰，形態(tài)不規(guī)則，彩色多普勒（CDF）及能量多普勒（CDE）未探及血流。術(shù)后1w、2w、4w腫瘤大小與術(shù)前相似，治療區(qū)呈不規(guī)則高回聲，中心見少量不規(guī)則無回聲；術(shù)后1w、2w，CDF及CDE無明顯血流信號，術(shù)后4w，CDE部分殘癌周邊見血流信號。 3.免疫組化結(jié)果 A組caspase-8在肝癌組織中呈低表達，為（9.4±2.3）%；B組caspase-8殘癌組織中陽性表達率為（12.6±2.9）%；C組caspase-8殘癌組織中陽性表達率為（45.8±12.8）%；D組caspase-8殘癌組織中陽性表達率為（76.7±15.5）%；E組caspase-8殘癌組織中陽性表達率為（96.6±18.3）%。B~E組caspase-8在消融區(qū)呈低表達。 結(jié)論：射頻消融術(shù)可以誘導(dǎo)兔肝VX_2腫瘤殘余瘤組織中的腫瘤細胞凋亡，從而起到進一步的治療作用。
[Abstract]:Part one: correlation analysis between ultrasound and enhanced CT in evaluating radiofrequency ablation of liver cancer
Objective: To investigate the correlation between ultrasound and enhanced CT in evaluating the therapeutic effect of radio frequency ablation (RFA) for hepatocellular carcinoma.
Methods: From January 2008 to December 2012, 124 patients with hepatocellular carcinoma were selected from the Second Affiliated Hospital of Dalian Medical University. There were 108 primary lesions, 40 metastatic lesions and 148 lesions. Correlation between sonographic changes and CT scan results.
Results: According to the lesion damage degree and time changes, the imaging manifestations of ultrasound and CT were positively correlated (P < 0.05).
Conclusion: Ultrasound and CT have their own advantages, but they are simple, economical, less time-consuming, less trauma, less complications, and can be used as the first choice for evaluating the efficacy of RFA.
The significance of caspase-8 expression in second cases of residual liver cancer after radiofrequency ablation of rabbit liver VX_2 tumor
Objective: To investigate the expression of caspase-8 in residual VX_2 tumor of rabbit liver after radio frequency ablation (RFA).
Methods: 28 experimental rabbits, 3 VX_2 tumor-bearing rabbits, 2 subcultured rabbits, and 23 intrahepatic inoculated rabbits were used. Fish-like tissues around the tumor were cut from the legs of the tumor-bearing rabbits and cut into tumors about 1 mm 3 in size. The VX_2 tumor particles were inoculated into the liver of 23 anesthetized experimental rabbits under the guidance of ultrasound. Two weeks later, the rabbit liver VX_2 tumor model was made randomly. Three rabbits were randomly divided into 5 groups, 3 in group A without RFA treatment, and the remaining 20 rabbits were treated with RFA, the lesion area was about half of the tumor. Five rabbits were divided into group B, group C, group D, and group E at different time points after treatment. Five rabbits were sacrificed after ultrasonic examination, and the remaining tumor tissues of liver VX_2 were detected by immunohistochemistry. The expression of caspase-8 in the treatment group.
Result:
1. modeling results
Ultrasound examination was performed 2 to 4 weeks after inoculation, and all 23 rabbits were successfully inoculated. Ultrasound showed round or quasi-circular hypoechoic nodules in the liver, with a clear border, no envelope echo, rich blood flow and arterial blood flow. Three rabbits were randomly selected and executed for HE staining. The tumor cells were nested, large in size and irregularly arranged. The nuclei were large and deep stained, indicating that the liver was successfully inoculated.
Ultrasonography after 2.RFA
The lesion showed irregular strong echo at 0 h after operation, unclear boundary, irregular shape, and no blood flow was detected by color Doppler (CDF) and energy Doppler (CDE). The tumor size was similar to that before operation at 1 w, 2 W and 4 W after operation, irregular high echo was found in the treatment area and a few irregular high echo was found in the center. E peripheral blood signals were seen in some residual cancers.
3. immunohistochemistry results
The expression of caspase-8 was low in group A (9.4 +2.3)%; positive in group B (12.6 +2.9)%; positive in group C (45.8 +12.8)%; positive in group D (76.7 +15.5)%; positive in group E (96.6 +2.9)%. 18.3) caspase-8 in%.B~E group was low expressed in ablation area.
CONCLUSION: Radiofrequency ablation can induce apoptosis of VX_2 tumor residual tissues in rabbit liver and play a further therapeutic role.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R445.1;R816.5;R735.7
本文編號：2203184
[Abstract]:Part one: correlation analysis between ultrasound and enhanced CT in evaluating radiofrequency ablation of liver cancer
Objective: To investigate the correlation between ultrasound and enhanced CT in evaluating the therapeutic effect of radio frequency ablation (RFA) for hepatocellular carcinoma.
Methods: From January 2008 to December 2012, 124 patients with hepatocellular carcinoma were selected from the Second Affiliated Hospital of Dalian Medical University. There were 108 primary lesions, 40 metastatic lesions and 148 lesions. Correlation between sonographic changes and CT scan results.
Results: According to the lesion damage degree and time changes, the imaging manifestations of ultrasound and CT were positively correlated (P < 0.05).
Conclusion: Ultrasound and CT have their own advantages, but they are simple, economical, less time-consuming, less trauma, less complications, and can be used as the first choice for evaluating the efficacy of RFA.
The significance of caspase-8 expression in second cases of residual liver cancer after radiofrequency ablation of rabbit liver VX_2 tumor
Objective: To investigate the expression of caspase-8 in residual VX_2 tumor of rabbit liver after radio frequency ablation (RFA).
Methods: 28 experimental rabbits, 3 VX_2 tumor-bearing rabbits, 2 subcultured rabbits, and 23 intrahepatic inoculated rabbits were used. Fish-like tissues around the tumor were cut from the legs of the tumor-bearing rabbits and cut into tumors about 1 mm 3 in size. The VX_2 tumor particles were inoculated into the liver of 23 anesthetized experimental rabbits under the guidance of ultrasound. Two weeks later, the rabbit liver VX_2 tumor model was made randomly. Three rabbits were randomly divided into 5 groups, 3 in group A without RFA treatment, and the remaining 20 rabbits were treated with RFA, the lesion area was about half of the tumor. Five rabbits were divided into group B, group C, group D, and group E at different time points after treatment. Five rabbits were sacrificed after ultrasonic examination, and the remaining tumor tissues of liver VX_2 were detected by immunohistochemistry. The expression of caspase-8 in the treatment group.
Result:
1. modeling results
Ultrasound examination was performed 2 to 4 weeks after inoculation, and all 23 rabbits were successfully inoculated. Ultrasound showed round or quasi-circular hypoechoic nodules in the liver, with a clear border, no envelope echo, rich blood flow and arterial blood flow. Three rabbits were randomly selected and executed for HE staining. The tumor cells were nested, large in size and irregularly arranged. The nuclei were large and deep stained, indicating that the liver was successfully inoculated.
Ultrasonography after 2.RFA
The lesion showed irregular strong echo at 0 h after operation, unclear boundary, irregular shape, and no blood flow was detected by color Doppler (CDF) and energy Doppler (CDE). The tumor size was similar to that before operation at 1 w, 2 W and 4 W after operation, irregular high echo was found in the treatment area and a few irregular high echo was found in the center. E peripheral blood signals were seen in some residual cancers.
3. immunohistochemistry results
The expression of caspase-8 was low in group A (9.4 +2.3)%; positive in group B (12.6 +2.9)%; positive in group C (45.8 +12.8)%; positive in group D (76.7 +15.5)%; positive in group E (96.6 +2.9)%. 18.3) caspase-8 in%.B~E group was low expressed in ablation area.
CONCLUSION: Radiofrequency ablation can induce apoptosis of VX_2 tumor residual tissues in rabbit liver and play a further therapeutic role.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R445.1;R816.5;R735.7
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本文編號：2203184
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