Auer Florian, Röper Barbara, Scheich Dieter, Molls Michael, Eiermann Wolfgang, Raab Günther
Department of Radiotherapy and Radiation Oncology, Klinikum rechts der Isar, Technische Universität, Munich, Germany.
Strahlenther Onkol. 2007 May;183(5):265-70. doi: 10.1007/s00066-007-1573-9.
Investigating tumor oxygenation in breast cancer with the Eppendorf device is hampered by the deep location and inadequate fixation of the tumor within the breast. In order to ensure the correct site of pO(2) measurements, guiding aids were introduced and the reliability of the refined method was evaluated.
For guidance of the needle electrode, a metal trocar was inserted up to the tumor rim. Its positioning and all transtumoral tracks of the needle electrode were monitored continuously by ultrasonography. Thus, 150 tumor measurements in 148 patients were evaluated. In a phantom, the possible influence of the metal trocar was assessed and the measurements of two histographs with five different needle electrodes were compared.
In 88% of measurements (132/150) complete or partial sonographic demarcation of the tumor was possible. 83.2% of the tracks (437/525) could be controlled by ultrasonography. Overall, in 60% of measurements (90/150) all values derived reliably from within the tumor. In vitro, an influence of the metal trocar on the measurements could be excluded. Differences between histographs were in accordance with tolerance limits.
From theoretical considerations and the phantom experiments a significant negative impact of the technical modifications could be excluded. Instead, the method described here showed to be beneficial in measuring tumor oxygenation in breast tumors. The authors strongly advise to consider exclusively intratumoral pO(2) values as proven by ultrasonography for oxygenation profiling, as in 40% of all measurements the origin of single pO(2) values or tracks was questionable.
使用Eppendorf装置研究乳腺癌中的肿瘤氧合受到肿瘤在乳腺内位置较深且固定不充分的阻碍。为确保pO₂测量的正确部位,引入了引导辅助工具并评估了改进方法的可靠性。
为引导针电极,将金属套管针插入至肿瘤边缘。通过超声连续监测其定位及针电极的所有经肿瘤轨迹。因此,对148例患者的150次肿瘤测量进行了评估。在体模中,评估了金属套管针可能产生的影响,并比较了使用五种不同针电极的两台组织血氧计的测量结果。
在88%的测量(132/150)中,可对肿瘤进行完全或部分超声界定。83.2%的轨迹(437/525)可通过超声控制。总体而言,在60%的测量(90/150)中,所有值均可靠地来源于肿瘤内部。在体外,可排除金属套管针对测量的影响。组织血氧计之间的差异符合公差限度。
从理论考虑和体模实验可以排除技术改进带来的显著负面影响。相反,此处描述的方法在测量乳腺肿瘤的肿瘤氧合方面显示出优势。作者强烈建议仅将经超声证实的肿瘤内pO₂值用于氧合分析,因为在所有测量中,40%的单个pO₂值或轨迹的来源存在疑问。