Han Bumsoo, Iftekhar Arif, Bischof John C
Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
Technol Cancer Res Treat. 2004 Apr;3(2):103-11. doi: 10.1177/153303460400300203.
In the present article, recent research efforts in our laboratory to improve cryosurgery by use of mechanistically derived adjuvants are reviewed. Our research has been focused on enhancing two freezing induced injury mechanisms - i) direct cell injury by use of thermophysical adjuvants, and ii) vascular injury by use of an inflammatory adjuvant. The thermophysical adjuvants are chemicals, usually salts, which can induce secondary crystallization, called eutectic solidification, in a cryolesion; thereby enhancing direct cell injury. The inflammatory adjuvant is a cytokine, tumor necrosis factor-alpha (TNF-alpha), which upregulates inflammation of microvasculature in tumors prior to freezing to promote vascular injury in the cryolesion. Even though the individual mechanism of injury enhancement within the cryolesion of each adjuvant requires further study, both adjuvants are envisioned to enlarge the complete killing zone so that the boundary of the cryolesion matches more closely with the edge of iceball. By bringing the edge of the cryolesion closer to the edge of iceball, the adjuvants hold promise for improvement of image guidance and outcome of cryosurgery.
在本文中，我们回顾了实验室最近利用基于机制的佐剂改进冷冻手术的研究工作。我们的研究集中在增强两种冷冻诱导的损伤机制——i）通过使用热物理佐剂造成直接细胞损伤，以及ii）通过使用炎性佐剂造成血管损伤。热物理佐剂是化学物质，通常为盐类，其可在冷冻损伤中诱导称为共晶凝固的二次结晶；从而增强直接细胞损伤。炎性佐剂是一种细胞因子，即肿瘤坏死因子-α（TNF-α），其在冷冻前上调肿瘤中微血管的炎症，以促进冷冻损伤中的血管损伤。尽管每种佐剂在冷冻损伤内增强损伤的具体机制仍需进一步研究，但预计这两种佐剂都能扩大完全杀伤区，使冷冻损伤的边界与冰球边缘更紧密匹配。通过使冷冻损伤的边缘更靠近冰球边缘，这些佐剂有望改善冷冻手术的图像引导和治疗效果。
