胶质瘤激光间质热疗的实验研究

Experimental study on laser interstitial thermotherapy for treatment of glioma

目的 探讨激光间质热疗（LITT）治疗胶质瘤的最适热功率、照射时间、热效应及作用机制。方法 将Walker胶质瘤细胞接种于大鼠后肢皮下,接种10d后瘤体直径达1.4～2.0cm。分别用钕钇铝石榴石（Nd-YAG）激光在2W、5W、10W三种低功率下进行间质热疗,激光作用时间分别为800s、800s和600s,并设立对照组。观察肿瘤直径、肿瘤病理组织学及超微结构的改变。结果LITT后3d及6d各治疗组与对照组肿瘤直径无显著差异（P>0.05）;LITT后9d及12d各治疗组肿瘤直径明显小于对照组（P<0.01）。治疗组肿瘤中心炭化,外围变性、坏死。治疗组肿瘤细胞超微结构也发生明显变化。结论 低功率Nd-YAG激光LITT可明显抑制胶质瘤的生长,具有良好的应用前景。

Objective To explore the optimal heating power, heating time, effects and mechanisms of laser interstitial thermotherapy (LITT) for treatment of glioma. Methods The Walker glioma cells were subcutaneously transplanted into the rear legs of rats, the diameters of tumors reached 1.4 - 2. 0 cm 10 days after transplantation. The neodymium yttrium aluminium garnet ( Nd-YAG) laser was applied for interstitial thermotherapy under low power of 2 W, 5 W and 10 W respectively, and for heating time of 800 s, 800 s and 600 s respectively, meanwhile the control group was established. The changes of diameter, pathology and ultrastructure of tumor were observed. Results No obvious changes of tumor diameter were found between each treatment group and control group on day 3 and day 6 after LITT ( P > 0. 05) , however the tumor diameters of treatment groups were all less than those of control group on day 9 and day 12 after LITT (P < 0. 01). The carbonization of center tissue, denaturation and necrosis of outer layer tissue were found in treatment groups. The ultrastructures of tumor cell in treatment groups changed markedly too. Conclusion The LITT with low power Nd-YAG laser can inhibit the growth of glioma obviously, which having excellent application prospect.