Department of Surgery, Institut Curie, René Huguenin Hospital, Saint-Cloud, France.
Tohoku J Exp Med. 2012 Jun;227(2):139-47. doi: 10.1620/tjem.227.139.
Tumor hypoxia is a hallmark of malignant tumors, and is a major factor in the resistance to anti-cancer therapies, particularly radiotherapy. Indeed, tumor blood flow often fluctuates, and thus the oxygen supply is often reduced, thereby inducing tumor hypoxia. We decided to explore whether post-occlusive reactive hyperemia, a physiological reaction known to occur in normal tissues, could be induced through a malignant tumor, basal cell carcinoma (BCC), in which angiogenesis occurs, as in all malignant tumors. Skin blood flow was measured in twelve patients with BCC, using Laser Speckle Contrast Imaging to determine BCC perfusion after three minutes of vascular occlusion, induced by limb tourniquet for limb tumors (4 BCC), and/or by clamping the pedicle of a skin flap with the BCC at its center, for other tumor locations (12 BCC). We demonstrated for the first time that post-occlusive reactive hyperemia occurs in malignant tumors in humans. BCC perfusion curves were similar to those of healthy skin, characterized by a peak of hyperemia after reperfusion followed by a progressive return to the pre-occlusion perfusion level. Induction of post-occlusive reactive hyperemia in malignant tumors is therefore a novel investigational approach that could lead to a new adjuvant tool to increase the efficacy of chemotherapy and radiotherapy, respectively through the synchronized temporary increase of tumor perfusion and oxygenation.
肿瘤缺氧是恶性肿瘤的一个标志，也是癌症治疗，特别是放射治疗耐药的一个主要因素。事实上，肿瘤血流经常波动，因此氧气供应经常减少，从而导致肿瘤缺氧。我们决定探讨在基底细胞癌（BCC）中是否可以诱导闭塞后反应性充血，这是一种已知在正常组织中发生的生理反应，BCC 发生血管生成，就像所有恶性肿瘤一样。我们使用激光散斑对比成像来测量 12 例 BCC 患者的皮肤血流量，以确定在肢体肿瘤（4 例 BCC）的肢体用止血带闭塞 3 分钟后和/或在 BCC 中心的皮瓣蒂夹闭后 BCC 的灌注。我们首次证明，闭塞后反应性充血发生在人类恶性肿瘤中。BCC 灌注曲线与健康皮肤相似，表现为再灌注后出现充血高峰，然后逐渐恢复到闭塞前的灌注水平。因此，诱导恶性肿瘤闭塞后反应性充血是一种新的研究方法，可能会导致一种新的辅助工具，分别通过同步增加肿瘤灌注和氧合来提高化学疗法和放射疗法的疗效。
