Moskalik K G, Alexeeva L N, Novik V I, Demin E V, Kozlov A P
Laboratory of High Energies, N.N. Petrov Research Institute of Oncology, St. Petersburg, Russia.
J BUON. 2011 Apr-Jun;16(2):341-4.
The neodymium (Nd) laser irradiation has been successfully applied to the treatment of slightly elevated skin melanoma. At the same time the histologic aspects of such a treatment have not been precisely investigated. The aim of this study was to retrace the histological features in human primary cutaneous melanomas after 1060 nm high energy mono pulsed Nd laser treatment in the dynamic healing of the affected tissues.
Histologic analysis of cutaneous melanomas irradiated by Nd laser was carried out. Tissue specimens were taken before and immediately after exposure to laser and 1 hour, and 1, 2 and 3 days after wards. Also the wounds that appeared after the scab fell off and the scars formed following laser irradiation were also the subject of histologic analysis at 2, 4 and 6 months post-treatment.
The Nd laser irradiation caused coagulation necrosis of melanoma, epidermis and dermis with skin appendices and superficial layers of subcutaneous fatty tissue. Foci of laser destruction were characterized by strict locality and efficient separation from the adjacent tissues, by the presence of stasis, thrombosis and coagulation of blood and lymphatic vessels. There was an increase of lymphocytes, macrophages and histiocytes in the area damaged by laser as well as in wounds and scars.
The pulsed Nd laser induces acute photothermal damages of melanoma tissue, which differs from the usual thermal lesions and the most critical difference of the effect of this modality is gain of immunocompetent cells in the affected tissue after laser beam application.
钕（Nd）激光照射已成功应用于治疗轻度隆起的皮肤黑色素瘤。与此同时，这种治疗的组织学方面尚未得到精确研究。本研究的目的是在受影响组织的动态愈合过程中，追溯1060nm高能单脉冲Nd激光治疗后人类原发性皮肤黑色素瘤的组织学特征。
对Nd激光照射的皮肤黑色素瘤进行组织学分析。在激光照射前、照射后即刻、照射后1小时以及照射后1、2和3天采集组织标本。此外，结痂脱落后出现的伤口以及激光照射后形成的瘢痕，也是治疗后2、4和6个月组织学分析的对象。
Nd激光照射导致黑色素瘤、表皮、真皮以及皮肤附属器和皮下脂肪组织浅层发生凝固性坏死。激光破坏灶的特征是位置局限，与相邻组织有效分离，存在血液和淋巴管的淤滞、血栓形成和凝血。在激光损伤区域以及伤口和瘢痕中，淋巴细胞、巨噬细胞和组织细胞增多。
脉冲Nd激光诱导黑色素瘤组织发生急性光热损伤，这与通常的热损伤不同，这种治疗方式最关键的差异在于激光束照射后受影响组织中免疫活性细胞增多。
