【摘要】：研究背景和目的結直腸癌是常見的消化道腫瘤,近年來我國結直腸癌的發(fā)病和死亡情況呈上升趨勢。因此結直腸癌早發(fā)現(xiàn)、早診斷、早治療尤為重要。物質在電磁場中表現(xiàn)出一定的電特性和磁特性,是其固有屬性,生物組織亦如此。電特性又稱介電特性,由電導率和介電常數(shù)兩個參數(shù)組成。研究表明,生物組織的介電特性具有頻率依賴性,并取決于組織的類型、含水量和溫度,其中組織含水量又是主要的影響因素。當組織發(fā)生癌變后由于其含水量比正常組織高,其介電特性也更高。本研究的開端同軸線射頻儀器具備適應超寬頻帶介電特性測量的結構,系統(tǒng)組成簡單、通用性強,對組織的物理形狀、尺寸沒作特殊要求,目前已成為最常用的測量組織介電特性的方法。對組織介電特性的認識可以幫助診斷惡性腫瘤、為腫瘤熱消融治療提供重要信息、應用于新興的MREPT技術。然而目前關于人體組織介電特性的研究局限于健康組織,腫瘤領域只有乳腺癌和肝癌有較深入的研究。有關結直腸癌組織介電特性的研究非常受限,基于這樣的研究現(xiàn)狀,本研究對結直腸癌組織的介電特性進行深入的研究,旨在探討應用開端同軸線射頻儀器測量的結直腸癌組織與正常組織之間、結直腸癌不同大體類型、分化程度、組織學分型、腫瘤浸潤深度、腫瘤分期對應的介電特性的差異。方法啟動開端同軸線射頻儀器,設置測量頻率為50-500MHz,依次進行開路、短路調試,隨后測量去離子水、甲醇、乙醇、正丙醇的介電特性。101名術前診斷為結腸/直腸癌的患者在手術室接受手術治療,由實驗操作者對新鮮離體的結直腸癌組織進行介電特性的測量工作,包括測量標本的腫瘤漿膜面、腫瘤粘膜面以及切緣粘膜面的相對介電常數(shù)和電導率。術后對標本行病理切片檢查,并對每例標本進行T和TNM病理分期。選取64、85、128、170、213、255、298、341、383、426和500 MHz的數(shù)據納入統(tǒng)計分析。結果101例標本病理結果均證實腫瘤病灶為結腸/直腸癌,標本的切緣均未見癌細胞。標本的離體時間為(10.30 ±8.50)min,每個測量點的測量時間為30s,實驗測量時間為(11.86 ±0.31)min。腫瘤漿膜面、腫瘤粘膜面、正常粘膜面三個位置的溫度差異比較無統(tǒng)計學意義(P0.05)。結腸與直腸組織之間的介電特性無統(tǒng)計學差異(P0.05)。腫瘤粘膜面的介電特性比正常粘膜面高(P0.01),其中相對介電常數(shù)平均高出8.98%;電導率平均高出11.01%。在對比結直腸癌不同大體類型、分化程度的介電特性差異時,發(fā)現(xiàn)均無統(tǒng)計學意義(P0.05)。對比結直腸癌不同組織學分型的差異,除341和500 MHz以外的其余頻率點,粘液腺癌在腫瘤粘膜面的電導率均比腺癌組織高(P0.05)。對比結直腸癌不同浸潤深度的差異,組織的介電特性隨T分期的升高而增加,≤T1(Tis+T0)、T2、T3、T4期之間的電導率差異共同在213和426MHz時具有統(tǒng)計學意義(P0.05)。≤T2與≥T3期之間相對介電常數(shù)和電導率的差異共同在213和426MHz具有統(tǒng)計學意義(P0.05)。對比結直腸癌不同TNM分期的差異,若分為≤1(0+1),Ⅱ,Ⅲ和Ⅳ期,在300MHz以內的絕大部分頻率點,四期在腫瘤漿膜面和腫瘤粘膜面的介電特性差異均有統(tǒng)計學意義(P0.05)。進一步多重比較時,整體表現(xiàn)出Ⅲ、Ⅳ期的相對介電常數(shù)和電導率比≤Ⅰ、Ⅱ期高(P0.05)。若分為≤Ⅱ和≥Ⅲ期,亦發(fā)現(xiàn)在300MHz以內,兩者的介電特性有統(tǒng)計學差異(P0.05)。結論應用開端同軸線法可以鑒別結直腸癌組織和正常組織,評估腫瘤組織學分型、浸潤深度、腫瘤分期。未來有望成為一種實時、快速、精準、有效的檢測結直腸癌的輔助診斷新技術,為正確地評估患者的預后、采取相應的個體化治療以及制定合理的手術策略提供重要的指導意義。
[Abstract]:The research background and the purpose of colorectal cancer are common digestive tract tumors. In recent years, the incidence and death of colorectal cancer in our country are on the rise. As a result, early diagnosis and early treatment of colorectal cancer are particularly important. The material exhibits some electric and magnetic properties in the electromagnetic field. It is the inherent property of the material, and the biological tissue is also the same. The electrical properties are also called dielectric properties, consisting of two parameters of conductivity and dielectric constant. The research shows that the dielectric properties of the biological tissue are frequency dependent and depend on the type of tissue, the water content and the temperature, in which the water content of the tissue is the main influencing factor. When the tissue is cancerous, its water content is higher than that of normal tissue, and its dielectric properties are also higher. The open-ended coaxial-line radio-frequency instrument of the present study is suitable for the measurement of the ultra-wide band dielectric property. The system is simple in composition, strong in universality, has no special requirements for the physical shape and size of the tissue, and has become the most commonly used method for measuring the dielectric properties of the tissue. The understanding of the dielectric properties of the tissue can help to diagnose the malignant tumor, provide important information for the treatment of tumor thermal ablation, and apply to the emerging MREPT technology. However, the current study on the dielectric properties of human tissue is limited to healthy tissue, and there is a deep study of breast cancer and liver cancer in the field of tumor. The study on the dielectric properties of colorectal cancer tissue is very limited, and based on the current status of the study, the study has conducted an in-depth study of the dielectric properties of colorectal cancer tissue, and aims at exploring the relationship between the colorectal cancer tissue and the normal tissue measured by the open-end coaxial radio frequency instrument, The difference of the dielectric properties of the different general types, the degree of differentiation, the type of the tissue, the depth of tumor invasion and the stage of the tumor. the method starts the coaxial-line radio-frequency instrument, sets the measurement frequency to be 50-500mhz, sequentially performs open-circuit and short-circuit debugging, and then measures the dielectric properties of the de-ionized water, the methanol, the ethanol and the n-propanol. the measurement of the dielectric properties of the tissue of the colorectal cancer of the fresh-off body was performed by the experimental operator, including the measurement of the relative dielectric constant and the electrical conductivity of the tumor serosa, the mucosal surface of the tumor, and the mucosal surface of the edge of the tumor. The pathological sections of the specimens were examined after operation, and the pathological stages of T and TNM were performed for each specimen. Data from 64, 85, 128, 170, 213, 255, 298, 341, 383, 426 and 500 MHz were selected for statistical analysis. Results The pathological results of 101 cases confirmed that the tumor focus was colorectal/ rectal cancer, and no cancer cells were found at the edge of the specimen. The body time of the specimen was (10.30 to 8.50) min, the measurement time of each measurement point was 30s, and the measurement time of the experiment was (11.86 to 0.31) min. There was no significant difference in the temperature difference between the serosal surface of the tumor, the mucosal surface of the tumor and the normal mucosal surface (P0.05). There was no statistical difference between the colon and the rectal tissues (P0.05). The dielectric properties of the mucosal surface of the tumor were higher than that of the normal mucosa (P0.01), and the relative dielectric constant was 8. 98% higher than that of the normal mucosa, and the average conductivity was 11.01% higher than that of the normal mucosa. There was no significant difference in the difference of the general type and the degree of differentiation of the colorectal cancer (P0.05). The difference of different histological grades of colorectal cancer, except 341 and 500 MHz, was higher than that of adenocarcinoma (P0.05). In contrast, the difference of different infiltration depth of colorectal cancer, the dielectric properties of tissue increased with the increase of T stage, and the difference of conductivity between T1 (Tis + T0), T2, T3 and T4 was statistically significant at 213 and 426MHz (P0.05). The difference of relative dielectric constant and conductivity between the period T2 and the period T3 was statistically significant at 213 and 426MHz (P0.05). In contrast, the difference of TNM stages of colorectal cancer was divided into two groups: 1 (0 + 1), 鈪，

本文編號：2414288