Wu F, Chen W Z, Bai J, Zou J Z, Wang Z L, Zhu H, Wang Z B
Clinical Center for Tumor Therapy of 2nd Affiliated Hospital and Institute of Ultrasonic Engineering in Medicine, Chongqing University of Medical Sciences, Chongqing, China.
Ultrasound Med Biol. 2001 Aug;27(8):1099-106. doi: 10.1016/s0301-5629(01)00389-1.
The purpose of this study was to investigate the pathologic changes of extracorporeal ablation of human malignant tumors with high-intensity focused ultrasound (HIFU). HIFU treatment was performed in the 164 patients with liver cancer, breast cancer, malignant bone tumor, soft tissue sarcoma and other malignant tumors at focal peak intensities from 5000 W x cm(-2) to 20,000 W x cm(-2), with operating frequencies of 0.8 to 3.2 MHz. To explore the pathologic impact of extracorporeal HIFU, 30 patients with malignant carcinoma underwent surgical removal after HIFU treatment. Pathologic findings showed that the treated tissues demonstrated homogeneous coagulative necrosis with an irreversible tumor cell death and severe damage to tumor blood vessels at the level of microsvasculature within the HIFU-targeted region. Thermolesions to intervening tissue were never observed. The treated region had a sharp border comprising only several cell layers between the treated and untreated areas. The repair of lesions had the processes of necrotic tissue absorption and granulation tissue replacement. It is concluded that extracorporeal treatment of human solid malignancies with HIFU could be safe, effective and feasible. As a noninvasive therapy, HIFU would be used clinically to treat patients with solid malignancies.
本研究旨在探讨高强度聚焦超声（HIFU）体外消融人体恶性肿瘤的病理变化。对164例肝癌、乳腺癌、恶性骨肿瘤、软组织肉瘤及其他恶性肿瘤患者进行了HIFU治疗，聚焦峰值强度为5000W·cm⁻²至20000W·cm⁻²，工作频率为0.8至3.2MHz。为探讨体外HIFU的病理影响，30例恶性肿瘤患者在HIFU治疗后接受了手术切除。病理结果显示，治疗后的组织呈现均匀性凝固性坏死，肿瘤细胞发生不可逆死亡，在HIFU靶向区域内的微血管水平上肿瘤血管受到严重损伤。未观察到对周围组织的热损伤。治疗区域边界清晰，在治疗区与未治疗区之间仅包含几层细胞。病变修复过程包括坏死组织吸收和肉芽组织替代。结论是，HIFU体外治疗人体实体恶性肿瘤安全、有效且可行。作为一种非侵入性治疗方法，HIFU将在临床上用于治疗实体恶性肿瘤患者。
