Roessler W, Rothgangel B, Hofstaedter F, Wieland W F
Department of Urology, Hospital St. Josef, Regensburg, Germany.
Urol Int. 1995;55(1):1-5. doi: 10.1159/000282736.
The effects of high-energy shock waves (HESW) on the human renal cell carcinoma were examined. The kidneys were available from 32 patients treated by radical nephrectomy due to renal cell carcinoma. Immediately after nephrectomy the kidneys were perfused with cold HTK solution and stored for a maximum of 4 h in hypothermia at 8 degrees C. The tumors were treated with 4,000 shocks (65 mPa = 0.6 mJ/mm2) in an electromagnetic lithotriptor (Siemens Co., Erlangen, Germany). Microscopic and immunohistological examinations of the tumors were performed after treatment, and cell proliferation rates of treated and untreated specimens were analyzed by cell cultures in 10 cases. HESW induce severe microscopic damage in the tumor tissue as complete rupture of the vessel walls and destruction of the tubular-formed tumor masses in the focal area. Immunohistochemistry shows intact immune reactive endothelial cells by factor 8-associated antibodies until the border to histological damage. Around this region a zone of negative antibody reaction against collagen type 4 is found. In cell cultures the proliferation rates of treated specimens were significantly lower compared to untreated. The human renal cell carcinoma seems to be susceptible for treatment with shock waves. HESW induce direct damage of tumor cells and vascular damage in the tumor which may be the primary cause of tumor necrosis.
研究了高能冲击波（HESW）对人肾细胞癌的影响。肾脏取自32例因肾细胞癌接受根治性肾切除术的患者。肾切除术后立即用冷HTK溶液灌注肾脏，并在8℃低温下保存最长4小时。在电磁碎石机（德国埃尔朗根西门子公司）中用4000次冲击波（65 mPa = 0.6 mJ/mm2）治疗肿瘤。治疗后对肿瘤进行显微镜和免疫组织学检查，并对10例病例的治疗和未治疗标本通过细胞培养分析细胞增殖率。高能冲击波在肿瘤组织中引起严重的显微镜下损伤，表现为血管壁完全破裂和局部区域管状肿瘤块的破坏。免疫组织化学显示，直到组织学损伤边界，因子8相关抗体显示免疫反应性内皮细胞完整。在该区域周围发现了针对IV型胶原的抗体阴性反应区。在细胞培养中，治疗标本的增殖率明显低于未治疗标本。人肾细胞癌似乎对冲击波治疗敏感。高能冲击波诱导肿瘤细胞直接损伤和肿瘤内血管损伤，这可能是肿瘤坏死的主要原因。
