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不可逆电穿孔后胰腺组织重塑与纤维化:组织病理学及热学视角

Pancreatic Tissue Remodeling and Fibrosis After Irreversible Electroporation: A Histopathological and Thermal Perspective.

作者信息

Kim Hong Bae, Youm Jin Young, Yang Joon-Mo, Sim Sung Bo

机构信息

Department of Biosystems & Biomaterials Science and Engineering, Seoul National University, Seoul 08826, Republic of Korea.

Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea.

出版信息

Biomedicines. 2025 Sep 10;13(9):2222. doi: 10.3390/biomedicines13092222.

Abstract

: Traditional thermal ablation for pancreatic cancer is limited by collateral injury, often leading to complications such as pancreatitis. Irreversible electroporation (IRE) is a non-thermal alternative. We investigated tissue responses in a porcine pancreas model, focusing on cell death, thermal effects, and fibrosis. : Seven pigs underwent pancreatic IRE via open surgery. Local tissue temperature was monitored near the electrode. Histological evaluation included H&E, TUNEL (apoptosis), Ki-67 (proliferation), vimentin (fibroblast activation), and insulin staining. Tissue remodeling was assessed at multiple time points up to 14 days. : IRE induced marked apoptosis within the ablated region, peaking at day 2. The maximum measured temperature was 78.4 °C. Over two weeks, fibrosis progressed with increased collagen and fibroblast activity. Regeneration was partial, with Ki-67-positive cell proliferation and gradual loss of insulin expression, while unablated tissue showed minimal damage. : IRE enables localized pancreatic ablation while sparing surrounding tissue. However, fibrosis limits full recovery. Limitations include small sample size, short follow-up, and species differences. Further studies are needed to refine IRE parameters and assess long-term functional outcomes.

摘要

传统的胰腺癌热消融术受到侧支损伤的限制,常导致胰腺炎等并发症。不可逆电穿孔(IRE)是一种非热消融方法。我们在猪胰腺模型中研究了组织反应,重点关注细胞死亡、热效应和纤维化。

七头猪通过开放手术接受了胰腺IRE治疗。在电极附近监测局部组织温度。组织学评估包括苏木精-伊红染色(H&E)、末端脱氧核苷酸转移酶介导的缺口末端标记法(TUNEL,用于检测凋亡)、Ki-67(用于检测增殖)、波形蛋白(用于检测成纤维细胞活化)和胰岛素染色。在长达14天的多个时间点评估组织重塑情况。

IRE在消融区域诱导了明显的凋亡,在第2天达到峰值。测得的最高温度为78.4℃。在两周多的时间里,随着胶原蛋白和成纤维细胞活性增加,纤维化进展。再生是部分性的,有Ki-67阳性细胞增殖和胰岛素表达逐渐丧失,而未消融的组织显示出最小程度的损伤。

IRE能够实现胰腺局部消融,同时使周围组织免受损伤。然而纤维化限制了完全恢复。局限性包括样本量小、随访时间短和物种差异。需要进一步研究来优化IRE参数并评估长期功能结果。

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