温控射频消融治疗VX2肝癌实验研究

Temperature-controlled radiofrequency ablation for the treatment of hepatocellular carcinoma VX2:an experimental study

目的探索不同温度控制条件下射频消融（RFA）治疗兔VX2肝癌后靶区内肿瘤细胞凋亡及增殖变化。方法采用开腹组织块法构建兔VX2肝癌模型，随机分为对照组（n=6，未行RFA）和实验组A组（n=24，射频针温度50—70℃）、B组（n=24，射频针温度70～90℃）、C组（n=24，射频针温度90～110℃）。实验组分别接受CT引导下不同温控RFA，靶区由消融中心向外周依次分为针道区、消融区和交界区；采用苏木精-伊红（HE）染色观察肿瘤及周围肝组织病理学变化．脱氧核糖核苷酸末端转移酶介导的缺口末端标记法（TUNEL）和增殖细胞核抗原（PCNA）免疫组化法检测各区带肿瘤细胞凋亡及增殖情况。结果RFA后实验组各组各区带6个时间点（术后即刻，1、3、7、14、21d）标本肿瘤细胞凋亡指数（AI）和增殖指数（PI）与对照组比较，均有统计学差异（P〈0．05）；B、C组区带各时间点AI均高于A组（P〈0．05），B、C组间无明显差异（P〉O．05）；术后7、14、21d时B、C组消融区和交界区P1均低于A组（P〈0．05），且术后21d时C组PI低于B组（P〈0．05）。结论RFA温控在50～110℃能达到基本灭活针道区兔VX2肝癌细胞的作用，选择90～110℃温控更利于彻底控制肿瘤。

Objective To explore the apoptosis and proliferation of tumor cells in target area of VX2 liver cancer rabbits after radiofrequency ablation （RFA） treatment under different temperature-controlled conditions. Methods Rabbit VX2 carcinoma model was established by using laparotomy and tissue block implantation method. The experimental rabbits were randomly divided into the control group （n =6,not receiving RFA）, the study group A （n=24, RF needle temperature 50℃-70℃）, the study group B （n=24, RF needle temperature 70℃-90℃）, and the study group C （n=24,RF needle temperature 90℃-110℃）. All rabbits in the three study groups received CT-guided RFA under different temperature-controlled conditions. The target area was divided, in the order from the ablation center to the periphery, into the needle area, the ablation area and the border area. After the treatment, tissue samples were collected. Hematoxylin and eosin （HE） staining was used to observe the pathological changes of tumor and the surrounding liver tissue. TdT-mediated dUTP nick end labeling assay （TUNEL） and proliferating cell nuclear antigen （PCNA） immunohistochemical method were employed to detect the tumor cell apoptosis and proliferation in each area. Results After RFA treatment, the apoptotic index （AI） and proliferation index （PI） of each area determined at six points of time （immediately after RFA, and at one, 3, 7, 14 and 21 days after RFA） in the three study groups were significantly different from those in the control group （P〈0.05）. AI values at each point of time in the study group B and C were significantly higher than those in the study group A （P〈0.05）, while no statistically significant ditI）rences existed between the study group B and the study group C （P〉0.05）. At 7, 14 and 21 days after RFA, PI values at the ablation area and the border area in the study group B and C were significantly lower than those in the study group A （P〈0.05）, besides, at 21 days after RFA, PI values of the study group C were significantly lower than those of the study group B （P〈0.05）. Conclusion t/FA ｜eml/）erature, when it is controlled within 50℃-110℃, can basically inactivate rabbit VX2 liver cancer cells in needle tract area, however, the use of 900C-110℃ temperature is more conducive to completely control the tumor.