Záruba P, Hoskovec D, Lacman J, Hořejš J, Krška Z, Ryska M
Rozhl Chir. 2015 Dec;94(12):504-9.
Irreversible electroporation (IRE) is a quite novel method of tissue ablation. Its mechanism of action that does not use thermal energy is the most important feature of the method. Current experience with IRE in animal studies and in clinical practice are summarized in the paper. In particular, the paper is focused on using IRE in locally advanced pancreatic carcinoma.
The basic principle of IRE is that it causes micropores in the phospholipid membrane of cells. This leads to an impairment of cellular homeostasis and programmed cell death - apoptosis. Because of absence of protein denaturation this method spares tubular structures like vessels and ducts. This is the key feature that allows to use IRE in the pancreas where common thermic ablative procedures cannot be used for difficult anatomic circumstances and resulting injury of surrounding structures. PRE-CLINICAL AND CLINICAL STUDIES: The ability to spare vascular structures and ducts was confirmed in many animal studies. Subsequently, IRE was safely utilized also in human liver, pancreas, lung and kidneys. IRE in the treatment of advanced pancreatic cancer: Most experience with IRE ablation has been gathered for locally advanced pancreatic carcinoma where clinical studies published in the recent 5 years have provided encouraging results.
Irreversible electroporation is a safe method used to decrease tumour mass in pancreatic cancer. Further studies are needed to determine its therapeutic efficiency.
不可逆电穿孔（IRE）是一种相当新颖的组织消融方法。其不使用热能的作用机制是该方法最重要的特征。本文总结了IRE在动物研究和临床实践中的当前经验。特别是，本文重点关注IRE在局部晚期胰腺癌中的应用。
IRE的基本原理是它会在细胞的磷脂膜上形成微孔。这会导致细胞内稳态受损和程序性细胞死亡——凋亡。由于不存在蛋白质变性，该方法可使血管和导管等管状结构免受损伤。这是一个关键特征，使得在胰腺中使用IRE成为可能，因为普通的热消融程序因解剖情况困难以及会对周围结构造成损伤而无法使用。临床前和临床研究：在许多动物研究中证实了IRE具有使血管结构和导管免受损伤的能力。随后，IRE也被安全地应用于人类的肝脏、胰腺、肺和肾脏。IRE在晚期胰腺癌治疗中的应用：关于IRE消融的大多数经验来自局部晚期胰腺癌，最近5年发表的临床研究给出了令人鼓舞的结果。
不可逆电穿孔是一种用于减少胰腺癌肿瘤体积的安全方法。需要进一步研究以确定其治疗效果。
