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使用扩散式探头的内镜超声引导激光消融术治疗局部晚期胰腺癌

Endoscopic Ultrasound-Guided Laser Ablation Using a Diffusing Applicator for Locally Advanced Pancreatic Cancer Treatment.

作者信息

Lim Seonghee, Truong Van Gia, Choi Jongman, Jeong Hye Jung, Oh Sun-Ju, Park Jin-Seok, Kang Hyun Wook

机构信息

Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan 48513, Korea.

Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon 22332, Korea.

出版信息

Cancers (Basel). 2022 May 2;14(9):2274. doi: 10.3390/cancers14092274.

DOI:10.3390/cancers14092274
PMID:35565403
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9102236/
Abstract

Endoscopic ultrasound (EUS)-guided cylindrical interstitial laser ablation (CILA) procedures can be used to treat unresectable pancreatic cancer (PC). The aim of this study was to investigate the acute responses of pancreatic tissue after EUS-guided CILA in vivo in porcine models. Eight pigs were tested to compare the effects of different energy levels on pancreatic tissue ablation. A 1064 nm laser system was used to deliver 5 W through a diffusing applicator. The EUS-guided CILA was performed under four different energies: 200, 400, 600, and 800 J. Three days after the experiments, histological analysis was performed. The CILA consistently generated circular coagulated necrosis (CN) in the cross-sectioned pancreatic tissue. The ablation diameter was linearly dependent on the total energy delivery. The area of the CN initially increased with total energy delivery but became saturated at 600 J. The width of the degenerative parenchyma (DP) in the native tissue beyond the CN region increased with the total energy up to 600 J, and then decreased afterward. EUS-guided CILA can be a feasible approach for treating PC. Further animal studies will investigate the chronic responses of the pancreatic tissue to examine the efficacy and safety of the proposed method for clinical translation.

摘要

内镜超声（EUS）引导下的柱状间质激光消融（CILA）手术可用于治疗无法切除的胰腺癌（PC）。本研究的目的是在猪模型体内研究EUS引导下CILA术后胰腺组织的急性反应。对8头猪进行测试，以比较不同能量水平对胰腺组织消融的影响。使用1064 nm激光系统通过散射探头输送5 W能量。在四种不同能量（200、400、600和800 J）下进行EUS引导的CILA。实验三天后进行组织学分析。CILA在横切的胰腺组织中始终产生圆形凝固性坏死（CN）。消融直径与总能量输送呈线性相关。CN面积最初随总能量输送增加，但在600 J时达到饱和。CN区域以外的天然组织中变性实质（DP）的宽度随总能量增加至600 J，随后减小。EUS引导下的CILA可能是治疗PC的一种可行方法。进一步的动物研究将调查胰腺组织的慢性反应，以检验所提出方法用于临床转化的有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/5e8ab1bf7b05/cancers-14-02274-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/6f7fff606cef/cancers-14-02274-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/bf0b75938495/cancers-14-02274-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/80a7de7bffdf/cancers-14-02274-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/f0408b1073b1/cancers-14-02274-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/5e8ab1bf7b05/cancers-14-02274-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/6f7fff606cef/cancers-14-02274-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/bf0b75938495/cancers-14-02274-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/80a7de7bffdf/cancers-14-02274-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/f0408b1073b1/cancers-14-02274-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a872/9102236/5e8ab1bf7b05/cancers-14-02274-g005.jpg

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