腹腔镜下冷循环射频消融治疗肾癌的病理及分子生物学改变

Histopathologic changes of laparoscopic cool-tip radiofrequency ablation for renal cell carcinoma

目的通过对比腹腔镜下冷循环射频消融(LCRFA)治疗肾癌前后的病理及分子生物学改变,探讨其临床有效性。方法对23例(肿瘤最大径<4.0 cm)的肾癌患者选择性实施LCRFA治疗,术中于射频消融前后分别取肿瘤组织活检,通过肿瘤标本HE染色、免疫组化检测Bcl-2、血管内皮细胞生长因子(VEGF)及TUNEL原位细胞凋亡检测对比LCRFA处理肿瘤前后肿瘤细胞的病理及分子生物学改变。结果LCRFA后肿瘤细胞凋亡检测阴性,Bcl-2、VEGF完全不表达,肿瘤细胞蛋白质、核酸变性凝固。结论LCRFA的热损伤可使细胞蛋白质、核酸变性凝固,肿瘤细胞坏死,达到灭活肿瘤细胞的目的。

Objective To investigate the histopathologie changes of laparoscopic cool-tip radiofrequency ablation （LCRFA） for renal cell carcinoma. Methods LCRFA was performed in 23 patients with small kidney carcinoma （〈4.0 em in diameter）. The tumor tissues were taken before and after LCRFA for observing the changes of histopathology with HE staining and detecting the apoptosis,VEGF and Bel-2 using immunohestichemistry and TUNEL methods. Results Compared to those before, the expressions of Bcl-2 and VEGF were all negative and the protein and nucleic acid of the tumor cells were degenerated and coagulated after LCRFA. Conclusion The protein and nucleic acid of the tumor cells were degeneration and coagulation by the thermal damage of LCRFA. The tumor cells can be thoroughly inactivated by LCRFA.