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超声引导下早期乳腺癌切除标本的射频消融治疗:进一步研究的启示。

Ultrasound-guided radiofrequency ablation of early breast cancer in a resection specimen: lessons for further research.

机构信息

Department of Surgery, Jeroen Bosch Ziekenhuis, PO Box 90153, 5200 ME 's-Hertogenbosch, The Netherlands.

出版信息

Breast. 2013 Aug;22(4):543-7. doi: 10.1016/j.breast.2012.11.004. Epub 2012 Dec 7.

Abstract

PURPOSE

To assess the feasibility and effectiveness of radiofrequency ablation (RFA) in breast cancer, using different histopathologic staining methods to evaluate tissue viability.

MATERIALS AND METHODS

In twenty patients with unifocal small (≤1, 5 cm) invasive ductal carcinoma, ultrasound-guided RFA was performed immediately after surgery. Cell viability was assessed using cytokeratin 8 (CK 8) and nicotinamide adenine dinucleotide diaphorase (NADHD) in addition to hematoxylin-eosin (HE).

RESULTS

At histopathological examination, ex vivo RFA resulted in complete cell death of the target lesion in 17/20 patients. In two cases viable ductal carcinoma in situ (DCIS) was found just outside the completely ablated lesion.

CONCLUSION

RFA of small invasive breast cancer seems to be a feasible treatment option. Both NADHD and CK 8 demonstrate a clear and comparable demarcation between viable and non-viable tissue. A high level of accuracy is required in proper positioning of the needle electrode and a "hot retraction" is mandatory.

摘要

目的

使用不同的组织病理学染色方法评估组织活力,评估射频消融 (RFA) 在乳腺癌中的可行性和有效性。

材料与方法

对 20 例单发小(≤1.5cm)浸润性导管癌患者,在手术后行超声引导下 RFA。除苏木精-伊红 (HE) 染色外,还使用细胞角蛋白 8 (CK 8) 和烟酰胺腺嘌呤二核苷酸脱氢酶 (NADHD) 评估细胞活力。

结果

在组织病理学检查中,20 例患者中有 17 例在体外 RFA 后,靶病变完全发生细胞死亡。在 2 例完全消融的病变外,仅发现活的导管原位癌 (DCIS)。

结论

RFA 治疗小的侵袭性乳腺癌似乎是一种可行的治疗选择。NADHD 和 CK 8 均能清晰、可比地区分存活组织和非存活组织。在正确放置电极针时需要高度准确,并且需要“热回缩”。

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