Department of Hepatobiliary and Pancreatic Surgery, Leicester Royal Infirmary, Leicester, UK.
Liver Int. 2010 Oct;30(9):1305-14. doi: 10.1111/j.1478-3231.2010.02290.x.
Renal changes after microwave tissue ablation (MTA) were compared with those following hepatic resection, cryotherapy (CRYO), and radiofrequency ablation (RFA). Structural damage producing renal impairment has been assessed directly by examining tissue specimens and by serum analysis for two sensitive biomarkers, retinol binding protein (RBP) and the heat shock protein 70 (HSP-70) for each modality at different ablation volumes.
Live rats underwent MTA, surgical resection, CRYO or RFA of 15, 33 or 66% of total hepatic volume. Urine and tissue samples were collected at the time of death. Percentage of tubules with casts and glomerular damage, tissue expression of HSP-70 and urine RBP were evaluated and compared. Behaviour of the animals was also assessed by means of five different parameters and combined to produce a response score.
All RFA and CRYO rats undergoing 66% died and these animals had >60% of damaged tubuli and 8% of altered glomeruli. No animals treated by MTA or surgical resection died. Cut-off values (those predicting fatal treatments) could be identified for levels of HSP-70 and RBP.
Large volume MTA is associated with a significant reduced renal damage and is well tolerated compared with RFA and CRYO.
比较了微波组织消融（MTA）后与肝切除、冷冻疗法（CRYO）和射频消融（RFA）后肾的变化。通过检查组织标本和血清中两种敏感生物标志物（每种方式在不同消融体积下的视黄醇结合蛋白（RBP）和热休克蛋白 70（HSP-70）），直接评估了导致肾功能损害的结构损伤。
活鼠接受 MTA、手术切除、15%、33%或 66%的总肝体积的 CRYO 或 RFA。在死亡时收集尿液和组织样本。评估和比较了管腔中有铸型和肾小球损伤的肾小管比例、组织中 HSP-70 的表达和尿液 RBP。还通过五个不同的参数来评估动物的行为，并将其组合成一个反应评分。
所有接受 66%CRYO 和 RFA 的大鼠均死亡，这些动物有 >60%的受损肾小管和 8%的改变肾小球。接受 MTA 或手术切除的动物没有死亡。可以确定 HSP-70 和 RBP 水平的临界值（预测致命治疗的那些）。
与 RFA 和 CRYO 相比，大体积 MTA 与显著降低的肾损伤相关，并且耐受性良好。
