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超声诱导高温对眼内恶性黑色素瘤的组织病理学影响

Histopathologic effects of ultrasonically induced hyperthermia in intraocular malignant melanoma.

作者信息

Coleman D J, Silverman R H, Iwamoto T, Lizzi F L, Rondeau M J, Driller J, Rosado A, Abramson D H, Ellsworth R M

机构信息

Department of Ophthalmology, Cornell University Medical College, New York, NY 10021.

出版信息

Ophthalmology. 1988 Jul;95(7):970-81. doi: 10.1016/s0161-6420(88)33088-5.

Abstract

Four cases of human intraocular malignant melanoma were treated with ultrasonically induced hyperthermia immediately before enucleation. Tumors were treated in two regimens: 30 minutes at 43 degrees to 45 degrees C and 5 minutes at greater than 50 degrees C. Temperatures were estimated from applied power levels, based on empirical data and mathematical models. Histopathologic changes observed in human tumors were compared with changes seen in malignant melanoma xenografts in athymic nude mice which were treated with ultrasonically induced hyperthermia for 30 minutes at 42 degrees to 46 degrees C. The effects of treatment were similar to changes seen in the animal model treated under analogous conditions: increased intercellular spacing, cytoplasmic vacuole formation, clumping of chromatin, breaks in cell membranes, and swelling and collapse of cells. Perivascular and peripheral zones sometimes showed decreased damage levels. The high temperature (greater than 50 degrees C) technique is presently being used as a means of "sterilizing" tumors before planned enucleation. The moderate temperature (43 degrees-45 degrees C) technique has been used in combination with radiotherapy to treat tumors when vision can be salvaged.

摘要

4例人眼内恶性黑色素瘤患者在眼球摘除术前立即接受超声诱导热疗。肿瘤采用两种治疗方案:43℃至45℃治疗30分钟,50℃以上治疗5分钟。根据经验数据和数学模型,通过施加的功率水平估算温度。将人肿瘤中观察到的组织病理学变化与无胸腺裸鼠恶性黑色素瘤异种移植物中的变化进行比较,这些裸鼠在42℃至46℃下接受超声诱导热疗30分钟。治疗效果与在类似条件下治疗的动物模型中观察到的变化相似:细胞间间距增加、细胞质空泡形成、染色质凝聚、细胞膜破裂以及细胞肿胀和崩解。血管周围和周边区域有时显示损伤程度降低。高温(高于50℃)技术目前被用作在计划眼球摘除术前“灭活”肿瘤的一种手段。当视力可以挽救时,中等温度(43℃-45℃)技术已与放射治疗联合用于治疗肿瘤。

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