Hansen E, Schlosser S, Altmeppen J, Kutz N, Knüchel-Clarke R, Taeger K
Klinik für Anästhesiologie, Universität Regensburg, Deutschland.
Beitr Infusionsther Transfusionsmed. 1994;32:502-4.
Intraoperative autotransfusion is contraindicated in tumor surgery because of the danger of tumor cell dissemination. We have tested the elimination of tumor cells in blood by irradiation for safe retransfusion. Tumor cells of various origin were mixed to washed red blood cells from volunteer blood donations. The blood was irradiated with 50 Gy. After isolation of the tumor cells by density gradient centrifugation they were tested for colony formation. While with different tumor cell lines (n = 12) 10 cells were sufficient to yield several colonies, as many as 10(10) cells did not result in any colony after irradiation of the blood. Similar results were obtained with cells cultured from blood salvaged during tumor surgery (n = 3), and with tumor cells prepared from various carcinomas (n = 10). Flow cytometric DNA analysis showed the irradiated cells in mitotic arrest. None of these cells had residual DNA metabolism expressed as incorporation of BrdUrd. We were able to demonstrate a rate of reduction in dividing cells of up to 10(9). With the typical irradiation sensitivity of tumor cells, with D0 values between 1 and 2 Gy, a dose of 50 Gy results in an effective log 12 reduction, sufficient for safe elimination of tumor cells found in shed blood. No adverse effects of the gamma-irradiation on the blood cells are to be expected, especially since the blood is retransfused without storage.
由于存在肿瘤细胞播散的风险，术中自体输血在肿瘤手术中是禁忌的。我们已经测试了通过照射来消除血液中的肿瘤细胞，以便安全地回输。将各种来源的肿瘤细胞与来自志愿献血者的洗涤红细胞混合。血液接受50 Gy的照射。通过密度梯度离心分离肿瘤细胞后，检测它们的集落形成情况。对于不同的肿瘤细胞系（n = 12），10个细胞就足以产生几个集落，而在血液照射后，多达10(10)个细胞却没有形成任何集落。从肿瘤手术中回收的血液培养的细胞（n = 3）以及从各种癌组织制备的肿瘤细胞（n = 10）也得到了类似的结果。流式细胞术DNA分析显示照射后的细胞处于有丝分裂停滞状态。这些细胞均无作为BrdUrd掺入表现的残留DNA代谢。我们能够证明分裂细胞的减少率高达10(9)。鉴于肿瘤细胞典型的辐射敏感性，D0值在1至2 Gy之间，50 Gy的剂量可导致有效的对数12减少，足以安全消除在失血中发现的肿瘤细胞。预计γ射线照射对血细胞不会产生不良影响，特别是因为血液在未储存的情况下就进行了回输。
