多极针射频消融术治疗肺癌的临床病理及免疫组化研究

Clinicopathologic and Immunohistochemical Study on Treatment of Lung Cancer by Multi-hook Radio-frequency Ablation

目的 :研究多极针射频消融术后肺癌临床病理学特点及其免疫组织化学表达特征。方法 :对 2 4例多极针射频消融术后肺癌标本进行病理形态学观察 ,并对 2 1例标本进行免疫组化分析 ,及对其中的 16例进行了随访。结果 :2 4例肺癌组织中 ,均见大片凝固性坏死 ,部分表现为多灶性点状坏死 ,伴有液化空洞 ,坏死灶中央及边缘可见散在的癌细胞核固缩、核碎裂 ,坏死灶边缘残留的癌细胞部分呈空泡变性及嗜酸性变 ,邻近的正常肺组织血管扩张、充血 ,但无明显的炎症反应。免疫组化表型 :PCNA阳性 17例 (81%) ,VEGF阳性 11例 (5 2 %) ,Bcl 2阳性 4例(19%)。 16例病人进行 4 - 9个月的随访 ,其中 7例病灶明显缩小 ,4例病灶无明显改变 ,3例病灶稍增大 ,2例死亡。结论 :多极针射频消融术对肺癌细胞具有明显的杀伤力 ,能抑制肿瘤组织的血管生成 ,近期疗效较满意。但为了彻底清除残留的肺癌细胞 ,还必须配合其它手段综合治疗 ,以达到更为理想的治疗效果。

Objective:To investigate the features of clinicopathology and immunohistochemical expression of lung cancer treated by multi hook radio frequency ablation.Methods:24 cases of lung cancer treated by multi hook radio frequency ablation were investigated in pathologic morphology.Twenty one cases treated by multi hook radio frequency ablation were analysed by immunohistochemistry.Follow up was done in 16 of the 21 cases.Results:Massive coagulation necrosis was observed in all cases.Multiple spotty necrosis was observed in some of them,with liquefaction and cavity noted at the same time.Karyopyknosis and karyorrhexis of cancer cells were seen scatterina at the center and in the edge of necrosis sections.Vacuolar degeneration and eosinophilic degeneration occurred in some of cancer cells left in the edge of necrosis sections.Blood vessels were dilated and hyperemic in adjacent normal lung tissues,but with no obvious inflammation.PCNA were positive in 17 cases (81%),VEGF positive in 11 (52%) and bcl 2 positive in 4 (19%).During the follow up of 4-9 months,focus was shrunken in 7 of 16 cases,unchanged in 4 cases,increscent in 3 cases,and 2 persons died. Conclusions:Powerful execution was observed which multi hook radio frequency ablation on lung cancer tissue.It could inhibit angiogenesis in tumors.The short term curative effect with multi hook radio frequency ablation on lung cancer tissue was satisfying.In order to eliminate the residual lung cancer cells,other combined treatments should be used at the same time.