高强度聚焦超声治疗兔移植性乳腺肿瘤的安全性评价

The safety evaluation of high intensity focused ultrasound for the treatment of implanted rabbit breast tumor

目的 :评价高强度聚焦超声 (HighIntensityFocusedUltrasound ,HIFU)治疗兔乳腺移植性肿瘤的安全性。方法 :4 0只兔乳腺移植性肿瘤于肿瘤移植后 11天随机分为治疗组 2 0只 ,手术组 10只 ,对照组 10只。治疗组接受HIFU覆盖治疗 ,手术组接受常规手术切除局部肿瘤 ,对照组接受假照治疗。采集辐照前后声像图进行对比性观察 ,于HIFU辐照后即刻切取肿瘤作肉眼观察 ,观察肿瘤的转移情况。HIFU辐照前后查肝功、生化及肾功 ,观察其变化。结果 :HIFU辐照前肿瘤声像图呈低回声团块 ,辐照后肿瘤声像图呈明显强回声。HIFU辐照前肿瘤切面呈粉红色 ,辐照后肿瘤呈白色凝固性损伤灶 ;治疗组和手术组的肿瘤转移率分别为 2 0 %和 30 % ,无显著性差异 (P >0 .0 5 ) ,均明显低于对照组 (10 0 % ,P <0 .0 5 )。HIFU辐照后治疗组动物的肝功、血生化及肾功与辐照前相比 ,以及手术组和对照组比较 ,差异无显著性 (P >0 .0 5 )。结论 :在B超实时监控下 ,HIFU准确有效地杀灭乳腺肿瘤 ,不增加肿瘤转移的危险性 ,对动物的肝功、血生化及肾功无影响。因此 ,HIFU治疗系统治疗是安全的。

Objective:To evaluate the safety of high intensity focused ultrasound(HIFU) for the treatment of implanted rabbit breast tumor.Methods:Forty New England rabbits were randomly divided into the following groups:HIFU treatment group(20),surgery group(10) and control group(10).HIFU ablation was performed at focal peak intensity 11500W/cm with a frequency of 1.6MHz in HIFU group.In surgery group all animals underwent lumpectomy.The animals in control group underwent pseudo-irradiation.The sonograms of target tumor were assessed before and immediately after HIFU ablation.The treated tumor was removed immediately after HIFU,and the lesion was measured by gross examination.Routine serum chemistry examination including hepatic,renal function tests,and serum electrolytes in all animals were performed before and at 1st,3rd,5th and 7th days after treatment.Also tumor metastases were observed after treatment.Results:The gray-scale of target tumors on ultrasound image was low before HIFU and increased immediately after HIFU irradiation.The hyperechoic location was the same as the lesion observed by gross observation.The necrotic lesion completely covered the tumor.No significant differences were observed in hepatic,renal function tests,and serum electrolytes before and after therapy in HIFU group.And these indices were not significantly different in HIFU treatment group,surgery group and control group,respectively.The metastatic rates of HIFU treatment group and surgery group were 20% and 30% respectively.They were significantly different from that of control group(100%,P<0.05).Conclusion:HIFU could precisely and effectively destroy the implanted rabbit breast tumor with guidance of ultrasound imaging.Because it does not increase the metastatic rate of tumor and affect the function of liver and kidney of animals,HIFU is safe for the treatment of breast carcinoma.