Earashi Mitsuharu, Noguchi Masakuni, Motoyoshi Ai, Fujii Hisatake
Breast Care Center, Yatsuo General Hospital, Toyama, Japan.
Breast Cancer. 2007;14(1):39-47. doi: 10.2325/jbcs.14.39.
There is increasing demand for minimally invasive treatment approaches. Although radiofrequency (RF) ablation therapy is promising for the local treatment of small, well-localized breast cancer, the problem of determining tumor cell death after RF ablation remains.
In the first series of this study, 17 patients underwent surgical resection immediately after RF ablation and 7 patients received delayed mammotome excision in the second series. The ablated tumor tissue was examined histologically with hematoxylin-eosin (H&E) staining and nicotinamide adenine dinucleotide (NADH)-diaphorase staining to assess tumor cell viability.
Histological examination with H&E staining revealed a spectrum of changes ranging from complete coagulation necrosis to normal-appearing tumor cells, although the degenerative changes were more remarkable in the second than in the first series. However, NADH-diaphorase staining revealed no viable tumor cells in the ablated lesion in either series.
NADH-diaphorase staining is essential to assess the effects of RF ablation. However, further studies are needed to determine whether RF ablation may provide equivalent local control and survival compared with conventional BCT for patients with small breast cancer.
对微创治疗方法的需求日益增加。尽管射频（RF）消融疗法在局部治疗小的、定位良好的乳腺癌方面前景广阔，但射频消融后确定肿瘤细胞死亡的问题仍然存在。
在本研究的第一组中，17例患者在射频消融后立即接受手术切除，第二组中有7例患者接受了延迟的乳腺旋切术切除。对消融的肿瘤组织进行苏木精-伊红（H&E）染色和烟酰胺腺嘌呤二核苷酸（NADH）-黄递酶染色的组织学检查，以评估肿瘤细胞的活力。
H&E染色的组织学检查显示，从完全凝固性坏死到外观正常的肿瘤细胞存在一系列变化，尽管第二组中的退行性变化比第一组更明显。然而，NADH-黄递酶染色显示两组中消融病变内均无存活的肿瘤细胞。
NADH-黄递酶染色对于评估射频消融的效果至关重要。然而，对于小乳腺癌患者，与传统保乳治疗相比，射频消融是否能提供同等的局部控制和生存率，还需要进一步研究。
