Thompson M A, Adelson M D, Jozefczyk M A, Coble D A, Kaufman L M
Department of Obstetrics and Gynecology, SUNY Health Science Center 13210.
Cancer. 1991 Mar 1;67(5):1326-31. doi: 10.1002/1097-0142(19910301)67:5<1326::aid-cncr2820670510>3.0.co;2-v.
For patients with ovarian epithelial cancer, survival increases when residual disease approaches zero after surgical removal of the tumor. A previous study using the Cavitron Ultrasonic Surgical Aspirator (CUSA) (Cavitron Lasersonic Corp., Stamford, CT) showed the successful removal of ovarian tumors from areas often considered unresectable: the diaphragm, spleen, stomach, and small bowel. However, the CUSA has not yet been approved by the Food and Drug Administration for gynecologic surgery except on an experimental basis. This study was designed to test whether ultrasonic irradiation produced by the CUSA caused alterations in cell structure or physiology of gynecologic tissue in adjacent areas. Paired tumor samples, unirradiated and irradiated, were obtained from ten patients, and portions were sent for pathologic structural evaluation and physiologic tissue culture evaluation. Histologic sections, stained with hematoxylin and eosin, showed that CUSA irradiation produced only minor tissue distortion as observed under the light microscope. A correct diagnosis would have been made in all cases had only tissue fragments obtained from the CUSA specimen trap been stained. For nine of ten patients, initial tumor cell viability was similar in the two specimen types. Flow cytometric DNA analysis confirmed that surgical methods produced matched samples. Cells that survived high-frequency ultrasound appeared functionally intact. For five of eight patients, the cells from the CUSA specimen traps survived and/or divided to a greater extent than those from the knife-dissected tumors. Cells from both surgical routes attained a similar number of passages in culture. It seems reasonable to extrapolate these in vitro observations with pelvic tumor tissues to normal surrounding tissue left in situ. Thus pelvic tissue is believed to be uninjured by CUSA ultrasonic irradiation.
对于卵巢上皮癌患者，在手术切除肿瘤后，若残留病灶接近零，则生存率会提高。此前一项使用Cavitron超声手术吸引器（CUSA，Cavitron Lasersonic公司，康涅狄格州斯坦福德）的研究表明，能够成功从通常被认为无法切除的区域（膈肌、脾脏、胃和小肠）切除卵巢肿瘤。然而，除了实验用途外，CUSA尚未获得美国食品药品监督管理局批准用于妇科手术。本研究旨在测试CUSA产生的超声辐射是否会导致相邻区域妇科组织的细胞结构或生理发生改变。从10名患者身上获取了成对的未照射和照射过的肿瘤样本，并将部分样本送去进行病理结构评估和生理组织培养评估。用苏木精和伊红染色的组织学切片显示，在光学显微镜下观察到CUSA辐射仅产生轻微的组织变形。如果仅对从CUSA标本收集器获得的组织碎片进行染色，那么在所有病例中都能做出正确诊断。对于10名患者中的9名，两种标本类型中初始肿瘤细胞的活力相似。流式细胞术DNA分析证实手术方法产生了匹配的样本。在高频超声下存活的细胞在功能上似乎是完整的。对于8名患者中的5名，来自CUSA标本收集器的细胞比来自手术刀切除肿瘤的细胞存活和/或分裂的程度更大。两种手术途径获得的细胞在培养中传代次数相似。将这些关于盆腔肿瘤组织的体外观察结果外推到原位保留的正常周围组织似乎是合理的。因此，盆腔组织被认为未受到CUSA超声辐射的损伤。
