Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, Xi’an, China.
J Ultrasound Med. 2012 Jun;31(6):863-71. doi: 10.7863/jum.2012.31.6.863.
The purpose of this study was to determine the minimum amount of healthy peripheral tissue that should be ablated when treating VX2 liver tumors with high-intensity focused ultrasound combined with an ultrasound contrast agent.
Fifty-one rabbits with hepatic tumors were established and randomly divided into the following groups: group A, which only had their tumors ablated; group B, which had their tumors and 2 mm of healthy adjacent tissue ablated; and group C, which had their tumors and 4 mm of healthy adjacent tissue ablated. The pathologic characteristics of the target tissue, serum alanine aminotransferase (ALT) level, presence of intrahepatic and distant metastases, and survival time between different groups were compared after high-intensity focused ultrasound treatment.
After ablation, coagulative necrosis was observed in all targeted tissue. The serum ALT level in group C was the highest and the level in group A was the lowest on the third and fifth days after ablation (P < .05), respectively. Fourteen days later, the serum ALT level in groups B and C decreased to normal, whereas the level in group A was abnormal and significantly higher (P < .05). Compared with group A, the prevalence of metastases in groups B and C was significantly lower (P < .05), and the survival time was significantly longer (P < .05); there appeared to be no statistically significant difference between groups B and C (P > .05).
Ablation of a tumor along with 2 mm of healthy surrounding tissue is a more effective strategy for treating hepatic cancer with high-intensity focused ultrasound coupled with an ultrasound contrast agent.
本研究旨在确定在高强度聚焦超声联合超声造影剂治疗 VX2 肝肿瘤时,应消融多少最小量的健康周围组织。
建立了 51 只患有肝肿瘤的兔模型,并将其随机分为以下三组:A 组,仅消融肿瘤;B 组,消融肿瘤及 2mm 健康相邻组织;C 组,消融肿瘤及 4mm 健康相邻组织。比较各组在高强度聚焦超声治疗后的靶组织病理特征、血清丙氨酸氨基转移酶(ALT)水平、肝内和远处转移的存在以及生存时间。
消融后,所有靶向组织均观察到凝固性坏死。C 组的血清 ALT 水平在消融后第 3、5 天最高,A 组最低(P<.05)。14 天后,B 组和 C 组的血清 ALT 水平降至正常,而 A 组异常且显著升高(P<.05)。与 A 组相比,B 组和 C 组的转移发生率显著降低(P<.05),生存时间显著延长(P<.05);B 组和 C 组之间无统计学差异(P>.05)。
在高强度聚焦超声联合超声造影剂治疗肝癌时,消融肿瘤及 2mm 健康周围组织是一种更有效的策略。